Learning Curve Of Complete Video-assisted Thoracoscopic Anatomic Segmentectomy For Non-small Cell Lung Cancer At Early-stage

Objective: To investigate the learning curve of Complete Video-assistedThoracoscopic（c-VATS）Anatomic Segmentectomy fortreatment of Non-SmallCell Lung Cancer (NSCLC) at Early-Stage. Methods: Retrospective analyseswere conducted of the clinical data of60patients with Early-Stage Non-SmallCell Lung Cancer， who underwent Complete Video-assisted ThoracoscopicAnatomic Segmentectomies between August2011to April2014performed by thesame surgical team from the Thoracic Surgery Department of Fujian MedicalUniversity Affiliated Union Hospital. According to the sequence of surgery， allpatients were equally divided into four groups（A、B、C and D， with15individuals in each group）. Comparisons were made among the four groups inoperating time，blood loss，numbers and stations of lymph nodes resected，rateof conversion to open surgery，complications，postoperative hospital stay and thefrequency of surgery．Results: No significant differences were found in age，sex，size of tumor among each group. The operating time was significantly longer ingroupA than in C and D[(207.3±44.1)min vs (173.0±25.3)min and （172.7±62.8)min，P <0．05]．The operating time of group B was （200.7±42.5）min，which was significantly longer than Group C and D too(P<0.05).However，neither between GroupA and B(P=0.611)， nor between Group C and D(P=0.980)were significant differences found in operating time. Statistics also indicate thatthe blood loss during operation was significantly more in Group A than in GroupC and D [（128.7±73.5）ml vs（79.3±43.0）ml and（78.0±43.6）ml，P<0．05]．Parients in Group B had more blood loss [(124.0±66.6)ml] than thosein Group C and D as well. Not only between GroupA and B (P=0.827)， but alsobetween Group C and D (P=0.950) did the blood loss reveal no significantdifference. All surgeries were performed successfully through completeVideo-assisted Thoracoscopic procedures without conversion to open surgery. There is no significant difference between numbers and stations of lymph nodesresected，complications and postoperative hospital stay among the four groups(P>0．05)．The frequency of surgery increased stably from2.7cases per month inGroupA to3.1cases per month in Group B，4.1cases per month in Group C and4.8cases per month in Group D. Conclusion:The learning curve of CompleteVideo-assisted Thoracoscopic Anatomic Segmentectomyfor NSCLC atEarly-Stage is approximately30cases．...