Comparison Of Video-Assisted Thoracoscopic Lobectomy And Conventional Thoracotomy For Primary Non-Small Cell Lung Cancer

Objective: To explore the clinical value of Video-assisted Thoracoscopic Lobectomy (VATS lobectomy)for primary non-small cell lung cancer.Method: From September 2007 to December 2008, consecutive 76 patients with non-small cell lung cancer were recruited. Thirty-seven patients underwent miniinvasive lobectomy (including 20 VAMT lobectomy and 17 VATS lobectomy) while thirty-nine patients underwent conventional posterolateral thoracotomy. Perioperative clinical parameters as well as the serum GLU,WBC and PA were compared.Result: There is no severe surgery-related complication and perioperative mortality and morbidity for both groups. Between two groups, no significant difference was found in intraoperative bleeding, duration of surgery and the number of lymph node dissection. The overall cost for a VATS lobectomy was a little more than an open lobectomy, but there was no significant difference. The patients who underwent VATS lobectomy had shorter incision length(7.6±1.9cm vs 28.5±3.6cm, P < 0.01), less dosage of dolantin(160±125mg vs 230±100mg,P<0.01), shorter chest tube time (4.8+2.5d vs 8.1+3.2d,P<0.01) and less length of hospital stay after surgery(12.1±3.0d vs 15.7±4.7d,P<0.01). The serum levels of glucose, white blood cells were significantly lower ( 7.2+1.2mmol/L vs 8.4+2.2mmol/L,P<0.01;12.7+3.8×109/L vs 15.1+5.9×109/L,P<0.05)and the prealbumin level was significantly higher(215.0+45.5 mg/l vs 147.3+50.8 mg/l, P<0.01)in the VATS group.Conclusion: Video-assisted thoracoscopic lobectomy offers less postoperative pain, a more rapid recovery as well as better cosmetic results than their conventional counterpart. VATS lobectomy is currently to be considered ideally indicated for early NSCLC and has its vast potential for future development.