Risk factors and 90-day mortality after video-assisted thoracoscopic lobectomy for lung cancer: the discussion is still open

American College of Chest Physician (ACCP) promotes the use of video-assisted thoracoscopic procedure over thoracotomy for patients with stage I NSCLC for anatomical pulmonary resection in experienced centers (1). Video-assisted thoracoscopic surgery (VATS) lobectomy has been demonstrated to be a safe, minimally invasive approach for the surgical treatment of lung cancer. Minimally invasive surgery seems to reduce postoperative morbidity and early mortality. For this reason it is currently the recommended surgical approach for early stage lung cancer surgical patients. But which are the real risk factors for vats lobectomy? And is thirty-day mortality an adequate quality indicator?