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Y. Sakata



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    P1.07 - Poster Session 1 - Surgery (ID 184)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Surgery
    • Presentations: 1
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      P1.07-009 - Preoperative simulation and navigation using the combination of high-speed 3D-image analysis system and Robotic surgery increase the efficacy and accuracy in thoracic surgery (ID 980)

      09:30 - 16:30  |  Author(s): Y. Sakata

      • Abstract

      Background
      Previously, we reported the utility of the da Vinci[®] Surgical System (dVS: Intuitive Surgical, Inc., Sunnyvale, CA) for various types of anterior and middle mediastinal tumors in clinical practice. We evaluated the feasibility, safety and appropriate settings of this system for the surgical treatment of these tumors. One review reports about the importance of the appropriate settings according to tumor location in robot-assisted thoracic surgery (RATS), because no target always exists in the same location within the thoracic cavity. In this report, we evaluated the efficacy of a high-speed three-dimensional (3D) image analysis system (SYNAPSE VINCENT; Fuji Photo Film Co., Ltd.) for preoperative simulation and navigation during a RATS procedure.

      Methods
      In this study, a high-speed 3D-image analysis system was used to decide the best positioning of robotic-arms and instruments preoperatively. Moreover, this system has capable of detecting the tumor location and extracting surrounding tissues quickly, accurately and safely. Accurate and speedy set-up of the da Vinci S[® ]Surgical System was possible for this operation. Synapse Vincent facilitated determining the best positioning of robot arms and instruments, and was an excellent device for navigation in real time. All patients who underwent RATS in our institution provided written informed consent to receive robotic surgery using the dVS, and the institutional review committees of each institution gave their permission. In this report, a representative mediastinal tumor which was located in the upper thoracic cavity was selected to establish the merits of this procedure.

      Results
      The patient, a 38-year-old woman, had a posterior mediastinal tumor located at the upper level of Th 1 to 3. Accurate and speedy set-up of the dVS was capable on this operation. It was feasible to decide the best positioning of robot-arms and instruments, and excellent device for the navigation on real time. The total operation time was 270 minutes, the time of the dVS setting was 21 minutes, and the console time (the dVS working time) was 132 minutes. The amount of bleeding was 167 mL and the drainage time was 2 days after the operation and this patient had no complications. The pathological report revealed a schwannoma (85 × 42 × 20 mm) with no malignancy.

      Conclusion
      For the optimal performance of RATS, the positioning of all units and the locations of instrument ports need suitable directional setting. Preoperative simulation and navigation during of operation using SYNAPSE VINCENT for the RATS has efficacy for planning the setting, especially in deciding the points of instrument ports and the angle of robot arms, and very useful as a device of the navigation software and education use operating on it.

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    P2.07 - Poster Session 2 - Surgery (ID 190)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Surgery
    • Presentations: 1
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      P2.07-029 - Clinical features and outcome of surgically resected secondary primary non-small cell lung cancer (ID 2607)

      09:30 - 16:30  |  Author(s): Y. Sakata

      • Abstract

      Background
      The incidence of a second primary lung cancer has been reported with 1-2% per patient year. Still, relatively few data has been published about this selected group of patients with sometimes conflicting results. Most data has been included low patient numbers that derived either from multiple institutions or from a long time period that may have rendered conclusions difficult caused by varying diagnostic procedures and therapeutic developments. Moreover, data regarding clinical characteristics is lacking for patients with first primary lung cancer who might be at risk for developing second primary lung cancer

      Methods
      From January 1999 to December 2008, 65 patients with second primary lung cancer, classified by the criteria proposed by Martini and Melamed, were treated at our Institution. We had 34 patients with a synchronous tumour and 31 with metachronous. As second treatment, we performed 11 lobectomies and 54 segmentectomies and widewedge resections. Histology was adenocarcinoma in 58, squamous in 4, adenosquamous in 8, large cells in 2 and pleomorphic in 1.

      Results
      Overall 5-year survival from second surgery was 69%; overall operative mortality was 0.65% (1 patient). Regarding the interval of surgery, the second operation had performed later than 2 years group showed a better 5-year survival than within 2 years group (80.6% and 69.2%, respectively, P = 0.008). Compared with lobectomies, segmentectomy showed a no significantly changes in survival rate(69 and 60%, respectively, P >0.051).

      Conclusion
      From our experience, lobectomy should still be considered as the treatment of choice in the management of second primary lung cancer, but sublobar resection remains a valid option in high-risk patients with limited pulmonary function.