Clinical Study of Pulmonary Lobectomy by Video-Assisted Thoracoscopic Surgery for Patients with Lung Cancer
|Keywords||video-assisted thoracic surgery(VATS) lung cancer pulmonary lobectomy systemic lymphadenectomy|
OBJECTIVE Our study is to make a Clinical Summary of video-assisted thoracic surgery pulmonary resection in our hospital during the past 3 years and evaluate the feasibility, Security and Clinical significance of video-assisted thoracic surgery pulmonary resection for patients with stage I and II non-small cell lung cancer.METHODS From January 2006 to January 2009,Our hospital had treated 68 cases with stage I and II non-small cell lung cancer by VATS,among which 63 cases successfully achieved VATS surgery.The clinic materials were reviewed and compared with other 48 cases receiving pulmonary lobectomy through conventional thoracic surgery in the same period.RESULTS In VATS group, 5 cases(7.4 %)were converted to open surgery. the number and range of lymph nodes dissected in the VATS group was comparable to those dissected in the conventional thoracic surgery group.No significant differences were decected between two groups in hilum of lung lymph nodes dissected[(2.75士2.28)vs(2.83士2.36 ),P>0.05], mediastinal lymph nodes dissected[(10.30士7.38)vs(13.42士6.23),P>0.05]. In two groups the incidence rates of postoperative complication were respectively 14.3%and 37.5%and there was significant difference(P<0.05 ). Operative bleeding, the mean frequency of analgesic treatment, the average duration of chest tube drainage, Chess drainage and Postoperative length of stay in hospital in the VATS group were significantly lower(P<0.05) than those in the conventional thoracic surgery group. There was no one who had Chronic pain and upper limb movement disorder after 2 months in the VATS group;while 7 patients had Chronic pain,among them 5 patients had upper limb movement disorder in the conventional thoracic surgery group(P<0.05). the VATS group mean operation time、hospitalization costs are little longer than the conventional thoracic surgery group,but there was no significant difference(P>0 .O5).CONCLUSION It is technically feasible and safe to perform pulmonary resection and systemic dissection of hilar and mediastinal lymph nodes by video-assisted thoracoscopic surgery for patients with stage I and II non-small cell lung cancer, but the radical effect needs to be further evaluation of follow-up study.And it has some advantages such as minimal damage, less bleeding, shorter recovery and better postoperative quality of life.VATS may be considered as a good option for patients with early non-small cell lung cancer,which is well worth developing and promoting.