Lobectomy by video-assisted thoracic surgery for primary lung cancer: experiences based on provisional indications.

A retrospective study on compromised patients who underwent a lobectomy by a standard thoracotomy for stage I non-small cell lung cancer revealed them to show a poor prognosis and quality of life due to their deteriorated physical conditions. Therefore, a lobectomy by video-assisted thoracic surgery (VATS lobectomy) was performed on some of these patients according to the provisional indications based on our retrospective study which indicated that it may be beneficial. Fourteen patients underwent VATS lobectomies (VATS group). Sixteen patients who underwent lobectomy by standard thoracotomy (ST group) were compared with those of the VATS group as historical controls. Although the mean operating time for the VATS group was longer than that for the ST group, there was no significant difference. The mean amount of blood loss for the VATS group was significantly less than that for the ST group. The mean maximal postoperative serum CPK level of the VATS group was slightly less than that of the ST group. A significant difference was observed regarding the changes in performance status both before and after operation between the VATS group and the ST group. We thus considered a VATS lobectomy to be beneficial for aged patients, especially in those with restricted physical conditions.