Video Assisted Thoracoscopic Surgery resection for minimally invasive lung cancer treatment. What are VATS benefits? Patient’s age and lung carcinoma therapy options. Dr. Anton Titov, MD. You are a world-class expert in minimally invasive lung cancer surgery. It's called Video Assisted Thoracoscopic Surgery. This is how you cured my mother of the lung tumor. What are options for minimally invasive lung cancer treatment? Dr. Anton Titov, MD. How to do lung tumor treatment for patients today? Dr. Michael Lanuti, MD. Yes, so the lung cancer therapy has really moved forward in that regard. So around the world and in the US, a video assisted approach to removing lung tumors revolutionized how we manage patients with lung cancer. Video assisted thracoscopic surgery improved how well lung cancer patients recover. Patients who are eligible for VATS generally have small lung tumors, Stage 1 tumors. They do not have a lot of lymph node involvement in cancer. On the other hand, we have extended VATS to those patients. Sometimes we think about the Video Assisted Thoracoscopic Surgery, the goal is not only for lung cancer but for other diseases inside chest. Sometimes we focus on lung cancer in this discussion, it would be lung tumors that are less than three centimeters. Such lung cancer tumors are generally located in the periphery of the lung. Dr. Michael Lanuti, MD. Sometimes lung adenocarcinoma tumors are starting to get larger than that or tend to move towards the center of the lung. Then then your ability to move things around in the chest with a camera and small instruments becomes more difficult. And so we tend to use the traditional open technique to treat such larger lung cancer tumors. Sometimes there's a lot of cancer lymph node involvement around the root of the lung, the hilum, those aren't typically amenable to a minimally invasive approach. Technology progresses for a Video Assisted Thoracoscopic Surgery for lung cancer therapy. Does it mean that there'll be a larger size tumors being accessible for the minimally invasive lung cancer treatment? Or is location of the lung tumor that is the most limiting factor for VATS? Dr. Michael Lanuti, MD. I think it's the location of the lung tumor. You could have a very large lung tumor in a lower lobe of the lung that you can move around in the chest. You will still be able to manipulate lung cancer with small instruments. So a very large tumor in the middle lobe wouldn't necessarily lend itself to being able to flip the lung back and forth. So you can work the small instruments and camera inside the lung. Minimally invasive lung cancer surgery often leads to faster recovery. Perhaps it is more suitable for more elderly patients. Dr. Anton Titov, MD. Is it something that you see with the VATS lung cancer surgery? Dr. Michael Lanuti, MD. It's clear that patients who had Video Assisted Thoracoscopic Surgery get out of the hospital a day or two sooner. Such lung cancer patients can get back to daily activity or work perhaps a week or two sooner. They can get into more lung cancer therapy like chemotherapy. They tend to be able to get to chemotherapy or radiotherapy faster. This is a huge advantage if you have patients who have more than Stage 1 lung cancer. So addressing the elderly patients, I do think that performing an open incision, a thoracotomy on an elderly patient has more consequences. It is best to do minimally invasive lung cancer treatment technique. To remove a lung lobe with an open technique clearly has more morbidity. Elderly lung cancer patients have more complications. Dr. Michael Lanuti, MD. And so we now can, with less complications, apply pulmonary surgery to patients in their seventh and eighth decade. We fear surgery less than we used to. Which indicates how my mother was 82 at the time of her lung tumor surgery. You were able to discharge her in great condition to home after just six days after surgery. Dr. Anton Titov, MD. So I think that's a case in point.
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