The feasibility study of single-direction complete video-assisted thoracoscopic lobectomy in the treatment of non-small cell lung cancer at clinical stage I-II

Objective To discussion the superiority and clinical application value of single-direction complete video-assisted thoracoscopic lobectomy and lymph node dissection in the treatment of non-small cell lung cancer at clinical stage I-Ⅱ.Methods Totally 140 consecutive patients with non-small cell lung cancer at clinical stage I-Ⅱ who underwent lobectomy between March 2010 and June 2011 were enrolled in this retrospective study.Of these patients,VATS group:70 patients were treated by single-direction complete video-assisted thoraeoscopie lobeetomy and lymph node dissection.In these patients,there were 15 cases received left upper lobectomy,and left 1ower lobectomy in 18 cases.Right upper lobectomy in 10 cases,right middle lobectomy in 10 cases,right lower lobectomy in 17 cases.The postoperative pathology diagnosis was squamous cell carcinoma in twenty-nine,adenocarcinoma in forty-one.Thoracotomy group:70 patients were treated by conventional thoracotomy and lymph node dissection.In these patients,there were 14 cases received left upper lobectomy,and left lower lobectomy in 20 cases.Right upper lobectomy in 10 cases,right middle lobectomy in 11 cases,right lower lobectomy in 15 cases.The postoperative pathology diagnosis was squamous cell carcinoma in thirty,adenocarcinoma in forty.Two groups were compared in operation time,surgical blood loss,the number of clean-up lymph nodes,chest tube placement time,posloperative chest drainage volume,postoperative hospitalization time.Results Thoracotomy group:Operation time was 106-210 min,average 162.1 min,surgical blood loss was 80-500 ml,average 178.9 ml,the number of clean-up lymph node was 10-22,average 17.0,chest tube placement time was 4-14 d,average 7.2 d,posloperative chest drainage volume was 910-3500 ml,average 1620.4 ml.Post-operative hospitalization days was 9-26 d,average 14.6 d.VATS group:Operation time was 85-200 min,average 131.9 min,surgical blood loss was 10-300 ml,average 98.4 ml,the number of clean up lymph node was 5-31,average 17.4,chest tube placement time was 3-20 d,average 6.0 d,posloperative chest drainage volume was 220-4710 ml,average 1417.8 ml.Post-operative hospitalization days was 7-17 d,average 11.2 d.Conclusions Completely video-assisted thoracoscopic lobectomy in the treatment of non-small cell lung cancer at clinical stage Ⅰ-Ⅱ is a safe,feasible mode of operation,this operation can reduce bleeding,shorter postoperative pleural drainage time and average hospitalization time,and does not increase postoperative complications,it can complete mediastinal and hilar lymph node dissection,be worthy of clinical application.