| ObjectiveWe performed a retrospective analysis of video-assisted lobectomy and traditional thoracotomy of non-small cell lung cancer with mediastinal lymph node dissection.Aimed to evaluate the effectiveness and risks between this two operation mode with mediastinal lymph node dissection.MethodsFrom January 2010 to July 2015,497 cases performed with lobectomy and sysmatic mediastinal lymph node diseection were devided into video-assited group(observated group)(n=242)and conventional lobectomy group(contrasted group)(n=255).The baseline data of two groups were 1:1 matched under Propensity Score Matching,the perioperative parameters,pathological types,numbers of mediastinal lymph node cleaning,and the rate of cN0-pN2 were comparated.ResultsIn totally,there was 497 cases under lobectmoy and systematic mediastinal lymph node diseection,accounting for 79.6%,and with 127 cases excepted,accounting for 20.7%.376 cases were matched under Propensity Score Matching,188 cases for each group.There was no statistically significant difference between two groups after matching(P>0.05).The mean set of mediastinal lymph node cleaning,for observated group was(4.14±0.57),and for contrasted group(3.97±0.62)(F=7.28,P<0.01);The mean number of removed mediastinal lymph nodes was(16.63±4.84)vs(17.32 ±3.63)(F=2.46,P=2.46).The mean number of group 7 lymph nodes for left side was,for observated group(7.25±2.13)and for contrasted group(8.78±2.91)(F=10.98,P<0.01),there was no statistically significant difference between other groups(P>0.05);The total transfered degree was 3.84%vs 4.33%(x2= 0.98,P=0.32),and the total transfered rate was 8.23%vs 7.36%(x2=0.39,P=0.39).Postoperative pathological were[adenocarcinoma(67.55%vs 68.62%,X2=0.05,P=0.82),squamous cell carcinomas(22.34%vs 23.94%,X2=0.13,P=0.71),and others(10.11%vs 7.44%,X2=0.83,P=0.36)].The mean operative time was[(153.24±21.91)min vs(162.23±22.75)min,F=15.23,P<0.01];The mean intraoperative blood loss was[(158.51 ±95.39)ml vs(166.49± 104.03)ml,F=0.60,P=0.44).Operative injures were[tracheal injury(1.59%vs 2.13%,X2=0.15,P=0.70),esophageal injury(0.53%vs 1.06,X2=1.06,P=0.56),laryngeal recurrent nerve injury(2.66%vs 1.59%,X2= 0.51,P=0.47),thoracic duct injury,1.06%vs 0.53%,X2=0.34,P=0.56),major vascular injury(3.19%vs 2.13%,X2=0.41,P=0.52);The mean chest drainage after 24 hours was[(252.85 + 129.81)ml vs(258.19 ± 105.34)ml,F=0.11,P=0.74];The postoperative complications were[hoarse(4.26%vs 3.72%,X2=0.07,P =0.79),arrhythmia(2.66%vs 3.19%,X2=0.09,P=0.76),chylothorax(1.59%vs 2.13%,X2=0.34,P=0.56)];The mean postoperative hospitalization days was[(9.02±3.61)d vs(10.18±3.97)d,F=8.85,P<0.01).ConclusionThere were advantages over postoperative recovery and shorting the hospitalization day of video-assisted lobectomy in non-small cell lung cancer with mediastinal lymph node dissection and the risk was not significantly increased,the overall effectiveness of mediastina]lymph node cleaning was similar to conventional surgery,but the ability of cleaning for group 7 lymph node was worse than conventional thoracotomy. |
PDF Full Text Request