Early experience on simultaneous mastectomy and video-assisted thoracoscopic surgery lobectomy via mastectomy incision


*Email: chongcn@surgery.cuhk.edu.hk


Aim:  To assess the feasibility of simultaneous video-assisted thoracoscopic surgery (VATS) lobectomy and mastectomy via the same incision in patients with synchronous primary carcinoma of the ipsilateral breast and lung.

Methods:  The patient was first positioned supine and modified radical mastectomy for the breast carcinoma was carried out in the standard way. After that, the mastectomy wound was partially closed and the patient was then turned into a full right decubitus position. Camera and instrument ports were inserted and a utility thoracotomy was made through the mastectomy wound. VATS lobectomy was then carried out.

Results:  From December 2007 to December 2008, three patients with synchronous primary breast and lung tumour received simultaneous mastectomy and VATS lobectomy through a single mastectomy incision in our institute. There was no operation-related mortality. The median operation time was 253 min (range 246–345 min) and the median blood loss was 250 mL (range 110–300 mL). All except one patient had uneventful postoperative recovery and deep vein thrombosis was noted in one patient.

Conclusion:  Simultaneous lobectomy through the mastectomy incision is a safe and feasible treatment option for ipsilateral pulmonary and breast lesion with encouraging outcome.