Learning Curve Of Complete Video-assisted Thoracoscopic Anatomical Obectomy Of Single-direction For Non-small Cell Lung Cancer At The Early-stage

Objective: To analysis of evaluation the Learning Curve of Complete Video-assisted Thoracoscopic Anatomical Obectomy of Single-direction for Non-small Cell Lung Cancer at the Early-Stage.Methods: Retrospective analyses were conducted of the clinical date of 80 patients with Early-Stage Non-small Cell Lung Cancer, who underwent Complete video-assisted Thoracoscopic Anatomical Obectomy of Single-direction for at the in our department between January 2012 and June 2012 Performed by the same surgical team from the Thoracic Surgery Department of Fujian Medical University Union Hospital. The clinical data of patients were retrospectively analyzed. According to the surgery date order is divided into four groups( A, B, C, D), 20 cases in each group,To various surgical operation time, intraoperative blood loss between the lymph node,station number and the number and incidence of postoperative complications, transfer rate of chest, chest tube placement time, postoperative hospitalization time, tumor size,analysis of different stages of the operation effect.Result: There was on difference among the four different groups in age,gender,lymph node cleaning station number and the number, postoperative morbidity,Transfer rate of thoracotomy, Chest tube placed time, Postoperative length of stay,tumor size, operation method, There was no statistically significant difference( P >0.05). Four group were Surgical time( F = 14.97, P = 0.000),( P < 0.05) was statistically significant; Intraoperative bleeding aspects( F = 12.558, P = 0.000),( P <0.05) was statistically significant. Operation time in group A( 230.2 ± 38.8) min and group B( 221.2 ±27.9) min, group C were significantly longer than the group D( 189.0 ± 16.5) min and( 186.2 ± 10.2) min( P < 0.05); Intraoperative blood loss of group A( 173.6± 26.7 ml) and group B( 169.0 ± 13.7)ml, were significantly higherthan that of group C( 148.0±15.4) ml( 147.5±9.1) ml and group D( P < 0.05);Between group C and D did the blood loss reveal and operation time is no significant difference( P > 0.05). Four groups of surgery patients were conducted under the Thoracoscope Completely,no transfer open chest, no intraoperative Complications.The postoperative Complications, a total of 9 cases( 11.25%), The postoperative pulmonary infection in 2 cases, 2 cases of group B, group A group D in 2 cases,Pulmonary infection in the fiber bronchoscope, sputum suction,anti-infection,eliminating phlegm to cured after treatment, Pneumonia with pleural effusion in 1 case, group C after anti-infection, phlegm, chest drainage tube after 5days after discharge; l cases of Group D atrial fibrillation after drug Cardioerter improved after treatment. 80 cases of postoperative patients were follow-up, telephone is given priority to periodic review with follow-up, follow-up time( 33-38 months),the average( 15.2± 7.4) months, no tumor recurrence or metastasis, as of the last follow-up, was not found in patients with clinical death. The frequency of surgery increased stably from 8.09 case per month in Group A to 10.9 cases per month in group B, 20.9 cases per month in group C and 23.3 cases per month in group D.Conclusion: To have certain Thoracotomy Lung resection of experience of the Surgeon, Learning curve of Complete video-assisted Thoracoscopic Anatomical Obectomy of Single-direction for Non-small Cell Lung Cancer at the Early-Stage is approximately 40 cases.