Modern radical resection for lung cancer; a critique on the video-assisted radical resection

The modern radical resection for the lung cancer consists of the parenchymal lung resection at least by tumor-bearing lobe and hilar/mediastinal lymph node dissection. For minimally invasive intent, the curative resection is being performed under video-thoracoscopy. The relative advantage over the conventional procedure under thoracotomy has yet to be defined in terms of operative indicators, postoperative pain, safety, cost, and so on. No previous study has ever clearly described the significant difference between these 2 procedures. The present thoracotomy-based radical resection has been fully down-sized together with advanced instrumentations, and the perioperative parameters between 2 procedures remained minimal. The evidence-based advantage of video-assisted radical resection needs to be addressed. Since their differences are solely concerned about the route of the approach into the thoracic cavity, the oncological difference reasonably does not seem to exist.