Clinical Study About Learning Curve Of Video-Assisted Thoracoscopic Surgery Lobectomy For Primary Lung Cancer

Objective: To evaluate the surgical outcomes of Video-Assisted Thoracoscopic Surgery Lobectomy for primary Lung Cancer and to define the learning curve of thoracoscopic lobectomy resection .Method: data of a succession of 90 cases of thoracoscopic lobectomy resection for primary lung cancer performed by the same team from December 2008 to February 2011 were reviewed. The patients were divided into 3 groups (group A, B, C n=30 in each group) according to the sequence of the operations. The outcomes of operating time,blood loss,post-operative complication,conversion rate into open surgery,postoperative chest tube drainage , hospital stay and number of dissected lymph node harvests of 3 groups were compared .Results: There was no significant difference among the patients to the three different phases with respect to age ,gender, size of tumor, pathological stage,operation pattern, past history of operation on Chest. The operation time in group A was (253.2±58.2min),significantly longer than that in group B (183.8±34.2 min)and group C (162.3±33.8 min)( P<0.05 )。The blood loss in group A was more than group B and group C [ (285±142.4ml) (154±73.2 ml) (148.6±75.5 ml)( P<0.05 ) ] ,but the operative time and blood loss between group B and group C have no significant differences。There was two cases of Pulmonary hemorrhage in group A。Conversion rate to open surgery in group A was 6.7% and declined to 3.3% in group B,but there was no significant differences。The number of dissected lymph node harvests,postoperative complications,chest tube drainage and hospital stay showed no differences between the three groups ( P>0.05 )。Conclusions: A learning curve for VATS lobectomy existed in this series. The surgeon became more pro?cient after 40 cases and was able to perform the procedure with decreased blood loss and operative time.