Thoracic Surgeons Introduce Less-Invasive Cancer Removal

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Thoracic Surgeons Introduce Less-Invasive Cancer Removal
October 1, 2005
ScienceDaily

— In a new procedure, called thorascopic lobectomy, surgeons make three small incisions in the chest and use specially designed instruments to reach the lungs. A camera helps them see the tumor and remove it with a bag. This prevents the cancer from spreading.

ANN ARBOR, Mich.--Each year, 170,000 Americans are diagnosed with lung cancer. Surgery to remove a lung tumor can be tough on patients and require them to stay in the hospital for up to a week. Now, a new surgery offers lung cancer patients a less painful recovery with the same success as the old procedure.

Walter Brossok, an ex-lung cancer patient, has 83 years worth of memories to tell his granddaughter about and is thankful he's alive to do it. A few months ago doctors told him he had lung cancer, but he was determined to beat it. "So, I have lung cancer. I'm going to get rid of it as soon as I can," he says.

Brossok was able to beat the cancer with a new type of surgery. Doctors told him recovery would be quick. "From lung cancer, you're going to be out of here the next day ... One day in the hospital bed, and then you're gone? I figured they're pulling my leg," Brossok says.

Thoracic surgeon Allan Pickens, from the University of Michigan in Ann Arbor, says most patients react the same way. "It is traditionally done through an open thoracotomy incision that is larger, involves splitting more muscle and actually spreading the ribs." But the new procedure -- called thorascopic lobectomy -- allows doctors to make three small incisions and use special instruments to reach the lungs. A camera lets them see the tumor and remove it with a bag, preventing the cancer from spreading.

"We don't have to make the larger incision. We don't spread the ribs at all, and patients have a shorter recovery time," Dr. Pickens says. After just one day, Brossok went home. He says, "I don't pray to God for anything ... He's got enough on his mind. When something good happens, like this, I thank God."

Candidates for the new surgery are patients with stage one or stage two lung cancer that has not spread to any other parts of the body.

BACKGROUND: A new surgical technique now being offered at the University of Michigan Comprehensive Cancer Center is helping people with early stage lung cancer recover more quickly with less pain. Among the first 1100 patients to receive the new surgery, mortality rates were below 1 percent, with minimal complications.

THE TECHNIQUE: The new technique is called thoracoscopic lobectomy. The surgeon makes three small incisions, each about an inch long. A camera is then inserted through a fourth incision just a fifth of an inch long. The camera allows the surgeon to see inside the chest to perform the surgery and remove the cancerous nodule. The procedure is ideal for the early stages of lung cancer, when the nodule is smaller than 2 inches, has not invaded the chest wall, and has not spread to distant organs.

BENEFITS: Unlike conventional lung surgeries, very little muscle has to be cut and the rib cage does not need to be spread. As a result, patients leave the hospital in half the time than they would with conventional lung surgery, with less need for narcotic painkillers. They can even return to work in only two weeks. Traditional lung cancer surgery is called a thoracotomy, in which the surgeon cuts through the muscles into the chest and spreads open the ribs to reveal the lungs. It requires a large incision over 7 inches long, and recovery is slow and painful. Because the technique removes the entire lobe, and can also be used to remove a portion of the lung (called a wedge resection), it may also eliminate the need for needle biopsies or additional surgeries.

ABOUT LUNG CANCER: The lungs are sponge-like organs found in the chest cavity. When we breathe, air goes into the lung through the windpipe (trachea), which is divided into smaller branches leading to tiny air sacs called alveoli. These contain tiny blood vessels that absorb oxygen from the inhaled air into the bloodstream and release carbon dioxide. Most lung cancers start in the lining of the smaller branches, developing over several years. The cancer cells produce chemicals that cause new blood vessels to form, which feed the cells until they form a tumor. Cells can break away from the original tumor and spread to other parts of the body, a process called metastasis. About 90 percent of lung cancers develop in smokers or former smokers. Symptoms of lung cancer include coughing up blood, shortness of breath or wheezing; chest pain; repeated chest infections, asthma, or fluid around the lung; and swelling in the neck or face.

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