French-window thoracotomy: postoperative pain avoidance for short-stay lung cancer surgery

Abstract Objective  Although long years have passed since video-assisted thoracic surgery (VATS) lobectomy (VL) appeared as a new approach for resection of lung cancer, its practicality is not clear even today. As the significance of VL has still been under discussion, it has not gained consensus of its superiority to standard lateral thoracotomy. However, we think that returning to the classical posterolateral thoracotomy (PLT) is only a setback, so we developed a new thoracotomy approach that spares the thoracic bony cage by protecting costovertebral and costosternal junctions without spreading the ribs, the same mechanism for avoiding pain as in VL. It was named French-window thoracotomy (FWT). Postoperative pain and length of hospital stay after pulmonary lobectomy were compared between PLT (n = 18) and FWT (n = 13).