Author of

• 11946

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  P2.24 - Poster Session 2 - Supportive Care (ID 157)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Supportive Care
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12006

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    P2.24-060 - VATS lobectomy using subcostal incision in NSCLC (ID 3490)

    09:30 - 09:30  |  Author(s): J.S. Shin
    • Abstract

    Background
    VATS lobectomy for Non-small cell lung cancer usually can be performed using one working window, and two or more ports for endoscopic instruments. The working window are made on the intercostal space space. However, these narrow Intercostal space could be the obstacle for the extraction of congested or huge resected lung lobe. So, we performed VATS lobectomy using 3 interocostal ports and the 3 cm subcostal incision.

    Methods
    Since March 2012, In Korea University Ansan Hospital, 20 VATS lobectomies was done for lung cancer. Of 20, we performed 4 cases of subcostal incision VATS lobectomy. At first, we performed entire procedure through the intercostal ports (10mm). After resection of lung, the subcostal incision (3cm ) was made anterior to the 10th rib. Because the 11th costal cartilage is abscent, there is no limitation during spreading the 10th intercostal space for the extraction of resected lung (Fig 1). And then, we dissect mediastinal lymph nodes systemically. During the subcostal incision, rectus muscle is resected partially. And the chest cavity was entered through the costophrenic junction. So,at the end the repair of diaphragm is needed. The chest tube can be placed properly through one of the intercostal ports.

    Results
    The characteristics of patients is summerized in Table 1.Of 4 cases of subcostal incision lobectomy, one case should be conversed to the anterior thoracotomy.That case was 6.5cm sized right middel lobe tumor.In the third case, we used two intercostal ports and one subcostal incision. In the question of post operative intercostal pain at operation day, patients did not complain severe pain (more than VAS score 5). However, we did not compare the pain score after this operation with conventional VATS lobectomy.

    Talble 1.The patient's characteristics

    Case No.	G/A	Lobe	Tumor size	LND	pTNM	3 ports	subcostal
    1	M/67	LLL	3.5cm	30	T2aN0M0	5th/6th/7th	3cm
    2	M/62	LUL	3.5cm	16	T2aN0M0	4th/6th/6th	3cm
    3	F/69	RUL	1.8cm	47	T1aN1M0	5th/6th	3cm
    4	F/43	RML	6.5cm	29	T2bN2M0	5th/6th/6th	1cm

    Figure 1 Fig 1. Three intercostal ports (10mm) and one Subcostal incision (3cm)

    Conclusion
    The subcostal incision for extraction of lung specimen was useful in VATS lobectomy.