Minimally Invasive Surgery for Lung Cancer: A Comprehensive Overview

In the fight against lung cancer, advances in medicine have brought a glimmer of hope. Although epidemiological data show that the incidence and mortality of lung cancer remain high, improvements in treatment methods have significantly increased the survival rate of patients. Especially for patients with early-stage lung cancer (Stage I and II), surgical resection is the preferred treatment. Whether using traditional thoracotomy or the widely adopted thoracoscopic technology, radical resection can be achieved. Thoracoscopic surgery, characterized by minimal invasiveness, enables faster recovery.

For very early-stage lung cancer, such as carcinoma in situ or minimally invasive adenocarcinoma, the 5-year survival rate after surgical resection can even reach 100%. Even for early invasive cancer, surgical resection can increase the 5-year survival rate to 85-90%. In contrast, if chemotherapy is chosen instead of surgery, the efficacy is difficult to compare with surgical resection due to the general effectiveness rate of current lung cancer chemotherapy drugs being only 30%-40%, making it hard to completely eliminate the tumor.

Therefore, for patients with early-stage lung cancer, surgical resection offers the best treatment outcome and survival prospects.

Understanding Minimally Invasive Surgery

Minimally invasive surgery has achieved major breakthroughs. Assisted by thoracoscopy, it only requires a small incision of 3 cm. This technique reduces the need for blood transfusion—95% of patients do not require transfusion. The operation time is shortened to within 2 hours, and the hospital stay is reduced from two weeks to one week. It improves the radicality of the surgery, increasing the 5-year survival rate by 6% and significantly enhancing the quality of life.

Benefits of Minimally Invasive Surgery

Ultra-minimally invasive surgery has revolutionized lung cancer treatment. It adopts general anesthesia without endotracheal intubation, eliminating the need for thoracic drainage tubes and urinary catheters. Patients regain consciousness half an hour after surgery, can drink water within 4 hours, and may be discharged within 6 hours. The risk of postoperative complications and infections is greatly reduced. This method is particularly suitable for early-stage lung cancer patients, and advanced age is not an absolute contraindication.

Comprehensive Guide to Lung Cancer Surgery Questions

Preoperative Questions

1. Can I be discharged on the same day after lung cancer surgery?

2. Can all early-stage lung cancer patients undergo minimally invasive thoracoscopic surgery? What are its advantages?

3. Before lung cancer surgery, a full-body evaluation is required, including enhanced CT and bone scan. What is the purpose of these tests? If distant metastasis is found, how will the treatment options change?

4. I have a 0.7 cm ground-glass nodule in the lung that has not changed since 2016. Do I need immediate surgery?

5. For a 1.5×1 cm ground-glass nodule, which is better: wedge resection or traditional lobectomy?

   
   

Postoperative Questions

1. Why does surgical resection of lung tissue not affect lung function in early-stage lung cancer?

2. If I experience pain in the inferolateral pectoral muscle after surgery, is this normal? How long will it last? What measures can relieve it?

3. As a Stage 3B lung cancer patient who has undergone pneumonectomy, do I need radiotherapy? If so, what are the risks and potential side effects of radiotherapy? How much does postoperative consolidation treatment improve survival rate?

4. Can Chinese patent medicines be used after surgery?

5. Is the risk of recurrence and metastasis really low for patients with minimally invasive adenocarcinoma after surgery?

   
   

Can I Be Discharged on the Same Day After Lung Cancer Surgery?

Traditional thoracotomy has significant limitations. It usually requires a large incision of 25-30 cm, causing severe trauma to the patient. Postoperative recovery is slow, and it may take 6 months to gradually recover. There are high intraoperative and postoperative risks, including complications such as pain, pulmonary infection, and heart failure.

Minimally invasive surgery has achieved major breakthroughs. Assisted by thoracoscopy, it only requires a small incision of 3 cm. It reduces the need for blood transfusion—95% of patients do not require transfusion. The operation time is shortened to within 2 hours, and the hospital stay is reduced from two weeks to one week. It improves the radicality of the surgery, increasing the 5-year survival rate by 6% and significantly enhancing the quality of life.

Can All Early-Stage Lung Cancer Patients Undergo Minimally Invasive Thoracoscopic Surgery? What Are Its Advantages?

In the treatment of early-stage lung cancer, the vast majority of patients can choose this minimally invasive approach unless they have severe cardiovascular and cerebrovascular diseases, cannot tolerate general anesthesia, or have severely impaired lung function. Compared with traditional thoracotomy, thoracoscopic surgery causes less bodily harm. Although the surgical scope is the same, the incision for thoracoscopic surgery is smaller, usually only 2-2.5 cm. This approach helps accelerate wound healing and immune recovery. Patients can usually be discharged 3-4 days after surgery, greatly shortening the hospital stay. In contrast, traditional thoracotomy requires a large incision of 20-30 cm, with stitches removed after 10-14 days, and patients need a longer time to fully recover for subsequent adjuvant treatment.

I Heard a Full-Body Evaluation Is Needed Before Lung Cancer Surgery, Including Enhanced CT and Bone Scan. What Is the Purpose of These Tests? If Distant Metastasis Is Found, How Will the Treatment Options Change?

For lung cancer patients, preoperative and postoperative full-body evaluations are important parts of the standard treatment process. These include tests such as enhanced CT and bone scan, whose purpose is to screen for distant metastasis. If metastasis is found, surgical treatment may not be applicable, as surgery mainly addresses local issues and is ineffective for distant metastasis. Therefore, it is recommended that patients undergo regular full-body evaluations to ensure timely detection and management of potential distant metastasis.

I Have a 0.7 cm Ground-Glass Nodule in the Lung That Has Not Changed Since 2016. Do I Need Immediate Surgery? How Should I Monitor This Nodule?

For a stable 0.7 cm ground-glass nodule with no changes since 2016, immediate surgery is not necessary. Generally, ground-glass nodules smaller than 6 mm and stable are recommended for continuous monitoring. If the nodule increases in size or shows other changes, surgical intervention may be necessary, and surgery can usually achieve clinical cure. Given that the patient’s nodule has not changed for five years, continued regular monitoring is recommended.

For a 1.5×1 cm Ground-Glass Nodule, Which Is Better: Wedge Resection or Traditional Lobectomy?

For a 1.5×1 cm ground-glass nodule, wedge resection can completely remove the tumor while preserving as much normal lung tissue as possible, which is crucial for postoperative quality of life and prognosis. Studies have shown that for peripheral pure ground-glass nodules smaller than 2 cm, local resection (including wedge resection or segmentectomy) has a similar prognosis to traditional lobectomy, without increasing the risk of recurrence or metastasis. Although local resection requires higher technical skills and needs to be performed by experienced doctors, it maximizes the preservation of lung function and improves the patient’s postoperative quality of life.

Why Does Surgical Resection of Lung Tissue Not Affect Lung Function in Early-Stage Lung Cancer?

Under normal physiological conditions, not all five lobes of the human lung are active. Therefore, when one lobe needs to be removed for medical reasons, the surgery usually does not have a significant impact on the patient’s daily life. After resection, the remaining lobes will compensate by expanding to fill the cavity, thereby maintaining relative stability of overall lung capacity functionally. With appropriate rehabilitation exercises and time, the patient’s lung function is expected to return to the preoperative level.

If I Experience Pain in the Inferolateral Pectoral Muscle After Surgery, Is This Normal? How Long Will It Last? What Measures Can Relieve It?

Pain in the inferolateral pectoral muscle after surgery may be caused by the surgical incision. Especially when the nodule is located under the armpit near the breast, the skin above the incision may bulge when standing after surgical suturing, leading to pain. Such pain may also occur in minimally invasive surgery.

As a Stage 3B Lung Cancer Patient Who Has Undergone Pneumonectomy, Do I Need Radiotherapy? If So, What Are the Risks and Potential Side Effects of Radiotherapy? How Much Does Postoperative Consolidation Treatment Improve Survival Rate?

Radiotherapy after pneumonectomy requires extra caution. Compared with conservative treatment alone, postoperative consolidation treatment can significantly improve the survival rate. However, due to the advanced nature of Stage 3B lung cancer, the risk of recurrence and metastasis is as high as 70%.

Can Chinese Patent Medicines Be Used After Surgery?

The use of Chinese patent medicines after surgery can be considered based on individual circumstances. They have the effects of regulating the body and enhancing immunity, which may help alleviate symptoms and reduce the risk of recurrence.

Is the Risk of Recurrence and Metastasis Really Low for Patients with Minimally Invasive Adenocarcinoma After Surgery?

Minimally invasive adenocarcinoma is a subtype of lung cancer with limited local invasion, usually within 5 mm, and has a low risk of distant metastasis. After surgical resection, patients have a high probability of achieving clinical cure, with a recurrence and metastasis risk of less than 1%. Therefore, patients with minimally invasive adenocarcinoma usually do not need subtype differentiation, unlike invasive adenocarcinoma.

In conclusion, minimally invasive surgery for lung cancer represents a significant advancement in treatment options. Its benefits include reduced recovery time, lower risk of complications, and improved survival rates. For patients facing early-stage lung cancer, this approach offers the best chance for a positive outcome.