Comparison of Video-assisted Thoracoscopic Lobectomy versus Open Thoracotomy for Primary Non Small Cell Lung Cancer - 269 Cases Single Cohort Study

Lobectomy versus Open Thoracotomy for Primary Non-Small Cell Lung Cancer: Single Cohort Study with 269 CasesM any centers worldwide perform lobectomy by video-as- sisted thoracoscopic surgery (VATS) as an alternative to open thoracotomy in suitable cases, especially in early stage non-small cell lung cancer (NSCLC) cases.[1] According to many studies, the advantages of VATS lobectomy compared to conventional open thoracotomy include shorter length of hospitalization, less postoperative complications, shorter duration of the chest tube, a more cosmetic incision, less postoperative pain, therefore better postoperative life quality and importantly similar overall survival rates compared to open thoracotomy.[2][3][4] VATS resections have become increasingly popular worldwide following the improvements in training programmes, drawing young surgeons' interest in VATS lobectomy, leading to increased experience.[5] In our Thoracic Surgery Clinic, VATS lobectomy is being performed since the beginning of the 2010s.VATS experience of Objectives: This study aims to compare the outcomes of video-assisted thoracoscopic surgery (VATS) lobectomy with open thoracotomy lobectomy in patients with non-small cell lung cancer (NSCLC).Methods: There were 269 cases with NSCLC who underwent lobectomy between 2017-2019; these cases were retrospectively studied.VATS lobectomy (VATS Group) and open thoracotomy lobectomy (Thoracotomy Group) patients' results were compared according to the length of hospitalizations, early postoperative complications and tumor size and stages.Results: VATS lobectomy was performed in 89 (33%) of these patients, whereas 180 (67%) patients underwent lobectomy using open thoracotomy for NSCLC.The findings showed that the average length of hospitalization was shorter in the VATS Group compared to the Thoracotomy Group (4 vs. 5.5 days) (p<0.05).It was found that the mean size of the tumour was smaller in the VATS Group when compared to the Thoracotomy Group (2.66 cm vs 3.97 cm) (p<0.001).Early postoperative complications were lower in the VATS Group (n=15, 16.8% vs n=58, 32.2%; p<0.021).Conclusion: In VATS lobectomy cases, postoperative complications are less, and the length of hospitalization is shorter.VATS lobectomy is mostly preferred smaller than 3 cm tumor size.