A natural way to extend the indications for video-assisted thoracoscopic surgery in patients with advanced lung cancer

Video-assisted thoracoscopic surgery (VATS) was first reported by Levi et al. in 1990 (1). VATS has become an attractive surgical procedure for benign diseases because of its low invasiveness (2,3). As experience performing VATS for benign diseases has accumulated, VATS has gradually begun to be used for lung cancer surgery. Since Roviaro et al. reported the first lobectomy using a videoendoscope for lung cancer, many investigators have used VATS for lung cancer operations and have reported the resulting outcomes (4). VATS is obviously superior to an open thoracotomy (Open) in terms of postoperative pain and cosmesis. However, the safety and adequacy of VATS for cancer operations needs to be confirmed.