Surgical Techniques for Non-Small Cell Lung Cancer
Summary
The surgical management of non-small cell lung cancer encompasses a spectrum of procedures aimed at complete tumour resection while preserving pulmonary function. Standard lobectomy remains the gold standard for peripheral lesions, involving removal of an entire lobe via thoracotomy, video-assisted thoracic surgery or robotic-assisted approaches. For centrally located tumours, bronchoplastic and arterial sleeve lobectomies allow preservation of lung parenchyma through en bloc resection of an involved bronchus or pulmonary artery segment with subsequent reconstruction. In more extensive cases, combined bronchovascular double-sleeve techniques or parenchymal-sparing pulmonary artery reconstructions may avoid pneumonectomy and yield comparable oncological outcomes. Pneumonectomy is reserved for tumours that cannot be addressed by sleeve resections but carries higher morbidity and functional impact. Advances in preoperative imaging, intraoperative navigation and enhanced recovery protocols have refined patient selection, reduced complications and improved long-term survival. The evolution of minimally invasive and hybrid approaches has further minimised surgical trauma while maintaining the radicality of resection.
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Surgical Techniques for Non-Small Cell Lung Cancer publication trend
The graph below shows the total number of articles in surgical techniques for non-small cell lung cancer across all publications each year (not limited to Nature Index journals).
Technical terms
Standard lobectomy: Surgical removal of one pulmonary lobe, typically via thoracotomy or minimally invasive approaches.
Sleeve lobectomy: Resection of a lobe with an adjacent segment of bronchus or artery and subsequent anastomosis to preserve lung tissue.
Pneumonectomy: Complete removal of one lung, indicated for extensive central tumours not amenable to parenchymal-sparing surgery.
Bronchoplasty: Reconstruction of the bronchial airway following partial resection to maintain ventilation to the remaining lung.
Anastomosis: Surgical connection of two structures, such as bronchial or vascular ends, during reconstruction.
References
- Complex Sleeve Lobectomy Has Lower Postoperative Major Complications Than Pneumonectomy in Patients with Centrally Located Non-Small-Cell Lung Cancer. Cancers (2024).
- Anastomosis Complications after Bronchoplasty: Incidence, Risk Factors, and Treatment Options Reported by a Referral Cancer Center. Current Oncology (2023).
- Parenchymal Sparing Surgery for Lung Cancer: Focus on Pulmonary Artery Reconstruction. Cancers (2022).
- Arterial Sleeve Lobectomy: Does Pulmonary Artery Reconstruction Type Impact Lung Function?. Cancers (2023).
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