Video-assisted Thorascopic Lymphadenectomy For Stage Ⅰ Non-Small Cell Lung Cancer

Objective To study the reliability and feasibility of video-assisted thorascopic lymphadenectomy for complete resection of non-small cell lung cancer(NSCLC).Methods Totally 140patients with clinical stage I lung cancer who underwent lobectomy with systemic mediastinal lymph node dissection(SND) between July 2006 and May 2010 were enrolled in this study.Of these patients,49 received complete Video-assisted thoracoscopic surgery (VATS)and other 91 cases through video-assisted mini-thoracotomy(VAMT). Completeness measured by the Operation time,the blood loss,the number of dissected stations and nodes,safety evaluated by postoperative drainage and SND-related complications(Chylothorax,injury of recurrent laryngeal nerve etc),the Postoperative drainage time,the amount of catheter drainage in postoperation and the hospitalization were compared between the two groups.Results The mediastinal lymph nodes stations dissected [ (6.39±1.27) stations VS (6.16±1.68) stations,t=1.811,P=0.419) ],number of mediastinal nodes dissected [(19.57±9.46)VS (17.10±8.88),t=1.536,P=0.127],and nodes dissected in each mediastinal zones(N1,N2 lymph) were not significantly different between the VATS and the VAMT.No significant difference was found in SND-related complication (2 cases of chylothorax in VATS group;2 cases of chylothorax in VAMT group,χ2 =0.389,P= 0.612). The postoperative drainage time,postoperative hospital stay and the pleural effusion drainage were all uncomparable between the two groups(P>0.05).Conclusion SND by VATS is as effective as VAMT with respect to completeness and safety issues.