PhD Defence Iris Elisabeth Wilhelmus Gerardus Laven

Keywords: Lung cancer, video-assisted thoracoscopic surgery, three-dimensional lung reconstruction, drainless surgery
 

"The next steps forward in progressive surgical lung cancer care"
 

Lung cancer remains a leading cause of cancer-related deaths. Early-stage lung cancer can be treated surgically with curative intent. This thesis explores three advancements beyond existing European “Enhanced Recovery After Surgery” guidelines to optimize lung surgery outcomes.

First, the adoption of the least invasive surgical approach called uniportal video-assisted thoracoscopic surgery (VATS) has shown to be oncologically safe, providing similar or better postoperative outcomes compared to the traditional multiportal VATS approach. Moreover, learning this approach is safe and can be achieved within 26 procedures. Second, three-dimensional lung reconstructions, using both commercial and open-source software, improve surgical planning by identifying anatomical variations and optimizing lung nodule localization. Lastly, a no-chest-drain policy for selected patients undergoing wedge resections reduces the length of hospital stay without compromising safety.

In conclusion, each of the innovations discussed in this thesis can further enhance surgical lung cancer care, offering improved recovery and outcomes for patients.

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