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Elkhayat et al. Mini-invasive Surg 2020;4:85 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2020.76

Editorial Open Access

Awake minimally invasive surgery as a game
changer in lung cancer

Hussein Elkhayat , Diego Gonzalez Rivas 2,3
1
1 Cardiothoracic Surgery, Faculty of Medicine, Assiut University, Assiut 71526, Egypt.
2 Department of Thoracic Surgery and Minimally Invasive Thoracic Surgery Unit (UCTMI), Coruña University Hospital, Coruña
15006, Spain.
3 Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China.

Correspondence to: Prof. Hussein Elkhayat, Cardiothoracic Surgery, Assiut University Hospitals, Assiut 71526, Egypt.
E-mail: dr_khayat@hotmail.com

How to cite this article: Elkhayat H, Gonzalez Rivas D. Awake minimal invasive surgery as a game changer in lung cancer. Mini-
invasive Surg 2020;4:85. http://dx.doi.org/10.20517/2574-1225.2020.76

Received: 28 Jul 2020 First Decision: 21 Aug 2020 Revised: 25 Sep 2020 Accepted: 14 Oct 2020 Published: 5 Dec 2020
Academic Editor: Marcelo F. Jimenez Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Surgery still offers the best option for patients with early stage non-small cell lung cancer that can tolerate surgery.
With the increase in screening programs, more patients are diagnosed at early stages of cancer. Sadly, not all of
them are fit for surgery, but with minimally invasive approaches, large number of those patients can be offered
surgery and get a better overall survival. Awake non-intubated video assisted thoracic surgery resection is one of
the most recent technique that we believe to be a game changer in this spectrum of patients who were previously
classified as medically inoperable.

Keywords: Video assisted thoracic surgery, stereotactic body radiotherapy, early stage, non-small cell lung cancer,
minimally invasive, inoperable

INTRODUCTION
With an increase in the number of patients diagnosed with early stage lung cancer, options for cure include
surgery and stereotactic body radiotherapy (SBRT). Recent guidelines published from ASTRO recommend
[1]
the use of SBRT in cases that medically inoperable . These results were augmented by the most recent
publication that found that median survival was significantly greater after surgery compared to SBRT
in a risk-adjusted matched cohort of patients judged to be surgical candidates. The authors recommend

© 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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and indicate if changes were made.

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