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Alexandre et al. Mini-invasive Surg 2020;4:35 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2020.07

Review Open Access

Quality of life, pain, and functional respiratory
recovery after lobectomy for early stage non-small
cell lung cancer: a review of the literature comparing
minimal invasive and open procedures

Goussens Alexandre, Lacroix Valérie

Department of cardiovascular and thoracic surgery, Cliniques Universitaires Saint Luc, Brussels 1200, Belgium.
Correspondence to: Dr. Lacroix Valérie, Department of cardiovascular and thoracic surgery, Cliniques universitaires Saint Luc,
Avenue Hippocrate 10, Bruxelles 1200, Belgium. E-mail: valerie.lacroix@uclouvain.be
How to cite this article: Alexandre G, Valérie L. Quality of life, pain, and functional respiratory recovery after lobectomy for
early stage non-small cell lung cancer: a review of the literature comparing minimal invasive and open procedures. Mini-
invasive Surg 2020;4:35. http://dx.doi.org/10.20517/2574-1225.2020.07
Received: 10 Jan 2020 First Decision: 10 Mar 2020 Revised: 12 Mar 2020 Accepted: 19 Mar 2020 Published: 18 Jun 2020

Science Editor: Giulio Belli Copy Editor: Jing-Wen Zhang Production Editor: Tian Zhang

Abstract
The recent improvement in surgical techniques for non-small cell lung cancer enables evident better results in term
of postoperative recovery with lower adverse events. Even though the interest in minimally invasive procedures has
increased, more subjective advantages are not always so apparent in the literature. There is indeed a growing interest in
the daily life of patients including their management of physical and emotional pain, the perception of quality of life, and
pulmonary function recovery. This review aims to highlight the advantages of minimal invasive surgery on pain, quality
of life, and functional pulmonary recovery after lobectomy alone for early stage non-small cell lung cancer. Minimal
invasive techniques or limited sparing open techniques offer better results in term of postoperative pain than open non-
sparing techniques, allowing a lighter analgesia protocol. However, these clear benefits seem to disappear in the mid-
term postoperative period. Studies suggest that minimal invasive surgery is non-inferior to thoracotomy in terms of
quality of life, and seems to give patients at least a better vision of their health, but larger-scale studies are needed to
demonstrate its superiority. Data show clear advantages in the postoperative pulmonary function recovery for minimal
invasive surgery compared to that of open procedures, although sparing and anterior incisions can show equivalence.
That benefit does not seem to persist in the mid and long term. Nevertheless, the posterolateral thoracotomy appears to
have the worse effect on the loss of pulmonary function.

Keywords: Lobectomy, lung cancer, quality of life, pain, pulmonary function

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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