BackTable Vascular & Interventional Ep. 605 Advanced Surgical Approaches in Lung Cancer Management with Dr. Scott Atay and Dr. Scott Oh
Jan 9, 2026
Dr. Scott Atai, a general thoracic surgeon at USC, and Dr. Scott Oh, an interventional pulmonologist, join the discussion on innovative lung cancer treatments. They explore the shift from traditional open thoracotomy to robotic and minimally invasive techniques. The duo emphasizes the importance of accurate mediastinal staging and the role of advanced bronchoscopic methods. They also share insights on managing multifocal lung cancers and preserving lung function while employing a multidisciplinary and personalized approach for long-term outcomes.
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Mediastinoscopy Is Largely Obsolete
- Mediastinoscopy is now rarely used and reserved for discordant PET/EBUS findings or very central stations.
- Combined EBUS-EUS gives the most complete minimally invasive mediastinal staging when indicated.
Combine EBUS And EUS For Staging
- Do combined EBUS-EUS when lymph node suspicion or location warrants complete mediastinal staging.
- Biopsy nodes ≥5 mm or smaller nodes with suspicious ultrasound features during the same bronchoscopic session.
Assess PFTs And Functional Reserve
- Always get spirometry and DLCO to estimate post-op predicted function and tolerance for lung volume loss.
- Use mobility and functional reserve clinically — not just numbers — to predict recovery and complications.