Nguyen maintained normal eating habits, experienced no cough, chest tightness, fever, or weight loss. An X-ray at Tam Anh General Hospital in Ho Chi Minh City revealed an opacity at the apex of his right lung. A subsequent CT scan showed a 2 cm tumor in the upper lobe of his right lung, which had invaded the chest wall, along with multiple small nodules on the pleura.

Associate Professor, Doctor Vu Huu Vinh, Director of the Thoracic and Vascular Surgery Center, stated that although the tumor was small, it showed signs of invading the chest wall and had spread to the pleura with small nodules. He emphasized that Nguyen required surgery to accurately determine the nature of the tumor and pleural nodules, and to prevent complications from the invasion.

Associate Professor Vinh (third from left) with the endoscopic surgical team operating on the patient. Photo: Tam Anh General Hospital

Following consultation, the surgical team opted for endoscopic surgery instead of open surgery due to the patient's history of pleural effusion, which had caused adhesions in the pleural cavity from previous inflammation and fibrotic reactions.

The team made three small incisions, each about 1 cm, on the chest wall. They then performed endoscopy to access the tumor in the upper lobe of the right lung, dissecting it from the lung parenchyma and chest wall, and removing the pleural nodules. All tissue samples were immediately sent to the laboratory for frozen section biopsy.

After about 40 minutes, the frozen section biopsy confirmed the tumor and pleural nodules were adenocarcinoma. The team proceeded to resect the upper lobe of the right lung containing the tumor and removed the lesions on the pleura to prevent cancer cells from spreading.

With the aid of a magnified endoscopic camera, doctors precisely detached the fibrotic structures. This approach reduced trauma, minimized blood loss, and accelerated the patient's recovery process.

According to Associate Professor Vinh, the surgery removed the primary tumor and helped stage the disease. This allowed doctors to develop a suitable multi-modal treatment regimen, such as chemotherapy, radiation therapy, or immunotherapy after surgery.

Globocan 2022 reported that Vietnam recorded over 24,400 new cases and nearly 22,600 deaths due to lung cancer. In its early stages, the disease often presents with no clear symptoms, making it easily mistaken or difficult to detect through routine examinations.

Associate Professor Vinh recommends that elderly individuals, current or former smokers, those working in dusty environments, or with a family history of lung cancer or chronic lung diseases, should undergo annual health check-ups and screenings as advised by a doctor. Early detection not only increases the chances of a cure but also allows for less invasive techniques, maximum lung preservation, and maintenance of physical condition and respiratory function after treatment.

Bao Anh

* The patient's name has been changed