Clinical Analysis Between Video-assisted Thoracoscopic Lobectomy And Conventional Lobectomy Via Open Thoracotomy On Non-small Cell Lung Cancer

Background and objective：Video-assisted thoracoscopic surgery(VATS)，a new developed minimallyinvasive technology, is widely used in the chest disease treatment.Currently VATSused to treat early non-small cell lung cancer has been widely accepted by the thoraciccounterparts,but it still has dispute on the understanding of this operationway.China-Japan union hospital thoracic surgery carried on the Video-assistedthoracoscopic surgery in2009,from then on,it’s technology has more and moremature gradually. At present we can already finish Video-assisted ThoracoscopicLobectomy of all lobes of the lung and mediastinal lymph node dissectionsskilly.Through continuous learning and practice, we have understanding andexperience of our own to this technology,only through an objective evaluation of theadvantages and disadvantages of this technology, find the necessary part ofimprovement and enhance, can we rise the perceptual knowledge to the rationalknowledge gradually.This paper’s purpose is to contrast the objective index ofvideo-assisted thoracoscopic lobectomy and conventional lobectomy via openthoracotomy on non-small cell lung cancer through the retrospective analysis of thepatients’ clinical data at China-Japan union hospital thoracic surgery in February toSeptember,2011,and to investigate the value of the Video-assisted ThoracoscopicLobectomy treatment on lung disease.Marerials and methods：Select non-small cell lung cancer patients who underwent lobectomy in ourdepartment, from February2011to September2011,we choose the patients underwent VATS lobectomy30cases as a research group (VATS group),21cases of men,9cases of women, aged45-74years old, with an average age of59.90±6.86years old.Then we choose the patients underwent the traditional open thoracic lobectomy58cases as a control group (TOS group),39cases of men,19cases of wome, aged48-71years old, with an average age of60.2±5.65years old.Watch the two groups’ index ofoperating time, peri-operative bleeding, intraoperative lymph node dissection number,postoperative pathologic stage, postoperative lead flow, time of pulling the tube,postoperative pain frequency, postoperative hospitalization time, postoperativecomplications and the charge of be in hospital.Results:Comparison of the general information: The observation group and controlgroup’ differences are not statistically significant (P>0.05) in age, gender structure,pathological feature, clinical stages and patients’ general, the index is comparable.Comparison of the oncology: The observation group compared with controls, thetwo groups’ differences are not statistically significant (P>0.05) in pathological typesproportion (6:24vs20:38) and pathologic stage proportion (11:18:1vs14:1); the twogroups’ differences are not statistically significant (P>0.05) in The number of lymphnodes N1N2station.Comparison of the postoperative clinical data: Compared the observation groupwith the control group in operating time, peri-operative bleeding, postoperative leadflow, time of pulling the tube, postoperative pain frequency, postoperativehospitalization time and the charge of be in hospital,it shows that patients of VATSgroups is less than TOS group in peri-operative bleeding (95.63±28.43:150.17±62.73)and postoperative opioid application DuLengDing number (0.7±0.89:1.30±1.21),drainage time (5.07±1.63:6.07±1.74) and postoperative always lead flow(1186.67±235.60:1633.53±288.06), and postoperative hospitalization time(8.87±1.11:9.60±1.22), the difference is statistically significant (P <0.05),while it is more than TOS group in operation time (174.47±17.94:139.67±29.63), total cost inhospital (36125±3805:31534±2350); The incidence of complications in VATS areless TOS group, the difference between two groups of patients is statisticallysignificant (P <0.05).Conclusions:1.Video-assisted thoracoscopic lobectomy compared with conventionallobectomy via open thoracotomy,it has some advantages such as less trauma,pain andcomplications, faster recovery.But it also has some disadvantages such as longerpostoperative hospitalization time and more charge of be in hospital.2. If strictly mastered the operation indication, the VATS can achieve completelylobectomy, and mediastinal lymph node dissection can achieve the same effect as theTOS.In short, the thoracoscope lobectomy is a safe, feasible and minimally invasivesurgery way, it should be actively promoting.