The Status Of Lymph Node Dissection And Its Relationship With The Learning Curve In Completed Video-assisted Thoracic Surgery Of Non-small Cell Lung Cancer

Objective:To investigate the status of lymph node dissection, learningcurve and clinical significance in completed VATS of non-small cell lungcancer.Methods: One hundred and two patients with lung cancer who receivedcompleted VATS lobectomy and lymphadenectomy by one group surgeons inour department from2012.2to2014.2were selected. The clinical data werecollected retrospectively. Male62cases, female40cases. Left upper lobe30cases, left lower lobe25cases, right upper lobe24cases, right middle lobe4cases, right lower lobe19cases. Divided into3groups (A, B, C), by operationsuccessively in turn, each group of34cases. The number of lymph nodestation dissection, number of lymph node dissection and number ofstation(2,4,7,10,11,12) lymph node dissection of3groups were compared. Toanalysis clinical significance of stages of the learning curve.Results:1A total of1,139lymph nodes were found in507areas. GroupA dissect lymph nodes144groups,315lymph nodes, Group B dissect lymphnodes167groups,357lymph nodes, Group C dissect lymph nodes196groups,467lymph nodes. Group A dissect the number of station(2,4,7,10,11,12)lymph node dissection was26,16,73,43,80,31. Group B dissect the number ofstation(2,4,7,10,11,12) lymph node dissection was23,46,90,38,70,32. Group Cdissect the number of station(2,4,7,10,11,12) lymph node dissection was58,63,122,52,57,36.2Three groups were statistically compared the number of lymph nodestation dissection(F=10.353,P<0.05).Between group C and group A, group Bwere statistically compared the number of lymph node dissection(F=6.371,P<0.05), no significance between group A and group B(P>0.05). 3Between group C and group A, group B were statistically comparednumber of station2lymph node dissection(F=3.551,P<0.05), no significancebetween group A and group B(P>0.05). Between group A and group B, groupC were statistically compared number of station4lymph node dissection(F=5.177,P<0.05), no significance between group B and group C(P>0.05).Between group C and group A, group B were statistically compared number ofstation7lymph node dissection(F=4.948,P<0.05),no significance betweengroup A and group B(P>0.05).4Three groups were no statistical differences compared the number ofstation(10,11,12) lymph node dissection.Conclusion:.1The scope of the lymph node were dissected more widely,and the number is increasing with VATS developed. But between early oflearning curve and middle of learning curve were no statistical differencescompared the number of lymph node station dissection.2The late of learning curve were dissected more the number ofstation(2,4,7) than early of learning curve. But between early of learning curveand middle of learning curve were no statistical differences compared thenumber of lymph node station(2,7) dissection. Between middle of learningcurve and late of learning curve were no statistical differences compared thenumber of lymph node station4dissection.3The among of early of learning curve, middle of learning curve and lateof learning curve were no statistical differences compared the number oflymph node station(10,11,12) dissection.