[Thoracoscopic Surgery] Thoracoscopic Radical Resection of Lung Cancer

Lung cancer is one of the fastest-growing malignant tumors in terms of incidence and mortality, posing the greatest threat to public health and life. It is one of the most common malignant tumors clinically, with the highest mortality rate among all cancers. The preferred treatment for lung cancer is comprehensive treatment primarily based on surgery. Traditional surgery involves open surgery with an incision of approximately 30-40 centimeters. This involves severing two layers of four major muscle groups in the chest and back that control shoulder joint and chest and back movement, using rib retractors to create sufficient space. This surgery is highly invasive, has many complications, and often results in long-term chest pain, limited upper limb movement on the operated side, and even affects daily activities such as combing hair and washing the face.

With continuous breakthroughs in medical technology, traditional, highly invasive open-chest surgery has been transformed into minimally invasive thoracoscopic surgery. Minimally invasive thoracoscopic techniques shorten the incision to approximately 8-10 centimeters, and with the addition of 2-3 auxiliary ports, it is possible to avoid cutting the chest and back muscles or ribs, thus reducing trauma.

Lung Cancer Classification:

By Location: Central; Peripheral

By Biological Classification:

Small Cell Lung Cancer: (15-20%)

Non-Small Cell Lung Cancer: (80-85%)

Squamous Cell Carcinoma, Adenocarcinoma, Large Cell Carcinoma

Adenosquamous Carcinoma

Others

Radical lung cancer surgery

This is a complete surgical procedure for lung cancer. In addition to removing the lung tissue containing the lung tumor, it also involves systematic lymph node dissection to minimize the risk of lung cancer recurrence.

Patients were placed in the lateral decubitus position on their healthy side. All surgeries were performed under general anesthesia with double-lumen endotracheal intubation. The entire procedure was performed using a Stryker thoracoscope. The incision was 1 cm long at the mid-axillary line in the 7th or 8th intercostal space. A 2 cm incision at the 8th intercostal space along the inferior angle of the scapula served as an auxiliary operating port. Depending on the patient's physique and chest shape, and the type of lobe to be removed, a 4 cm incision was made at the anterior axillary line in the 4th or 5th intercostal space as the primary operating port. No thoracotomy instrument was placed in this port, and the ribs were not retracted. All surgeries were anatomical lobectomies, and the surgical principles and thoroughness of resection were the same as for open lobectomies. If the lobe fissure was well-differentiated, the blood vessels and bronchi were usually treated through the fissure. If the lobe fissure was incompletely differentiated, a unidirectional lobectomy method was used. First, the pulmonary veins were treated, then the bronchi were cut, and finally the arterial branches were treated. The lobe was then completely removed along the incompletely differentiated interlobar fissure using an endoscopic linear suture incision device, placed in a specimen bag, and retrieved through the operating port. Blood vessels were stapled using white cartridges with a height of 2.5 mm, while bronchi were stapled using green cartridges with a height of 4.8 mm. After complete lobectomy, systematic mediastinal and hilar lymph node dissection was performed.

Post-operative Precautions

1. Avoid spicy, stimulating, and overly greasy foods. Develop good personal habits, such as quitting smoking and alcohol, which is beneficial for post-operative recovery.

2. Eat plenty of nutritious foods rich in protein to maintain a balanced diet. Eat easily digestible foods to aid in the absorption of protein and nutrients.

3. Eat plenty of fresh fruits and vegetables, as well as foods that can cleanse the lungs, all of which are beneficial for post-operative recovery. Also, change unhealthy cooking habits. People who cook frequently have twice the incidence of lung cancer compared to those who don't.

4. Supplement your diet with Vitamin C and drink plenty of warm water to enhance your immunity.

5. Engage in regular physical exercise to prevent other diseases.