Short-term Clinical Outcomes of Complete Video-assisted Thoracoscopic Lobectomy for Early-stage Lung Cancer_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

CAIHai-bo ,  LIYing-xin , ZhANGShi-fa , GAOLian-fang , ZHOUGuang-hua

Department of Thoracic and Cardiovascular Surgery, the First People's Hospital of Jining, Jining 272111, Shandong, P. R. China;

Corresponding author：

LIYing-xin, Email: liyinxin919@sina.com

Keywords：

Video-assisted thoracoscopic surgery; Lobectomy; Lung cancer; Lymph node dissection

DOI：

10.7507/1007-4848.20140065

Video：

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Objective To investigate the feasibility,safety and short-term clinical outcomes of complete videoassisted thoracoscopic surgery (VATS) lobectomy for patients with early-stage lung cancer (LC). Methods Clinical data of 138 consecutive patients with early-stage LC who underwent lobectomy in the First People's Hospital of Jining from January 2012 to May 2013 were retrospectively analyzed. There were 71 patients undergoing complete VATS lobectomy including 39 male and 32 female patients with their age of 57.9±10.6 years (VATS group) and 67 patients undergoing lobectomy via traditional thoracotomy including 36 male and 31 female patients with their age of 60.3±8.2 years (thoracotomy group). Operation time,intraoperative blood loss, groups and number of lymph node dissection,thoracic drainage duration, postoperative hospital stay,vision analogue scores (VAS) on the 1st,3rd and 30th postoperative day, and postoperative morbidity were compared between the 2 groups. Results All the patients in both groups success fully received their operation. Intraoperative blood loss (147±113 ml vs. 146±91 ml) number of lymph node dissection (9.9±3.6 vs. 10.0±3.6) group of lymph node dissection (3.1±1.3 vs. 3.4±1.3) and VAS on the 1st and 3rd postoperative day of VATS group were not statistically different from those of the thoracotomy group (P>0.05). Operation time (119±27 minutes vs. 135±29 minutes) thoracic drainage duration (3.0±0.9 days vs. 3.8±1.2 days) postoperative hospital stay (8.0±2.1 days vs. 10.2±5.4 days) VAS on the 30th postoperative day (2.6±0.7 vs. 3.2±1.1) and postoperative morbidity (8.5% vs. 19.4%) of VATS group were significantly shorter or lower than those of the thoracotomy group (P<0.05). Fifty-nine patients in VATS group and 58 patients in the thoracotomy group were followed up for 2-18 months after disc harge. During follow-up,there was no death in either group. There was 1 patient with brain metastasis,1 patient with liver metastasis,and 2 patients with bone metastasis. Conclusion Complete VATS lobectomy is safe and feasible for the treatment of early LC with the advantages of minimal invasiveness,less morbidity,better postoperative recovery and less chronic incision pain. Complete VATS lobectomy can also achieve similar standardization of lymph node dissection as routine thoracotomy.

Citation： CAIHai-bo, LIYing-xin, ZhANGShi-fa, GAOLian-fang, ZHOUGuang-hua. Short-term Clinical Outcomes of Complete Video-assisted Thoracoscopic Lobectomy for Early-stage Lung Cancer. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(2): 224-227. doi: 10.7507/1007-4848.20140065 Copy

1.	姜冠潮,杨帆,王俊.胸腔镜肺叶切除手术治疗非小细胞肺癌新进展.中华胸心血管外科杂志,2010,26 (5):291-293.
2.	蒲强,刘伦旭,马林,等.单向式胸腔镜肺叶切除安全性及技术可行性研究——附1040例报告.四川大学学报:医学版,2013,44 (1):109-113.
3.	Aoki T,Tsuchida M,Hashimoto T,et al.Quality of Life after lung cancer surgery:video-assisted thoracic surgery versus thoracotomy.Heart Lung Circ,2007,16 (4):285-289.
4.	Tajiri M,Maehara T,Nakayama H,et al.Decreased invasiveness via two methods of thoracoscopic lobectomy for lung cancer,compared with open thoracotomy.Respirology,2007,12 (2):207-211.
5.	Nomori H,Horio H,Naruke T,et al.What is the advantage of a thoracoscopic lobectomy over a limited thoracotomy procedure for lung cancer surgery? Ann Thorac Surg,2001,72 (3):879-884.
6.	Jemal A,Bray F,Center MM,et al.Global Cancer statistics.CA Cancer J Clin,2011,61 (2):69-90.
7.	Siegel R,Naishadham D,Jemal A.Cancer statistics,2013.CA Cancer J Clin,2013,63 (1):11-30.
8.	Chen WQ,Zeng HM,Zheng RS,et al.Cancer incidence and mortality in China,2007.Chin J Cancer Res,2012,24 (1):1-8.
9.	翁姗姗,李龙芸,宋伟,等.低剂量螺旋CT对肺内结节的诊断价值.癌症进展,2011,9 (1):7-12.
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12.	Ilonen IK,Räsänen JV,Knuuttila A,et al.Anatomic thoracoscopic lung resection for non-small cell lung cancer in stage I is associated with less morbidity and shorter hospitalization than thoracotomy.Acta Oncol,2011,50 (7):1126-1132.
13.	初向阳,薛志强,刘毅,等.单操作孔电视胸腔镜肺叶切除术治疗早期肺癌的临床研究.中国胸心血管外科临床杂志,2012,19 (2):113-115.
14.	Mahtabifard A,Dearmond DT,Fuller CB,et al.Video-assisted thoracoscopic surgery lobectomy for stage I lung cancer.Thorac Surg Clin,2007,17 (2):223-231.
15.	高珂,刘早阳,吴剑,等.单向式全胸腔镜肺叶切除术治疗早期非小细胞肺癌的临床疗效分析.中国胸心血管外科临床杂志,2011,18 (3):231-235.
16.	何建行,刘会平,杨运有.电视胸腔镜肺癌根治术5年临床疗效.中国胸心血管外科临床杂志,2002,9 (1):29-31.
17.	Ettinger DS,Akerley W,Borghaei H,et al.Non-small cell lung cancer.J Natl Compr Canc Netw,2012,10 (10):1236-1271.
18.	Kim K,Kim HK,Park JS,et al.Video-assisted thoracic surgery lobectomy:single institutional experience with 704 cases.Ann Thorac Surg,2010,89 (6):S2118-S2122.
19.	蒋伟,奚俊杰,王群,等.全胸腔镜肺癌根治术淋巴结清扫的探讨.中国微创外科杂志,2012,12 (11):969-972,975.
20.	李强,何金涛,庄翔,等.电视胸腔镜微创手术与常规肺癌手术淋巴结清扫的对照研究.中国肺癌杂志,2010,13 (12):1141-1144.
21.	Sakuraba M,Miyamoto H,Oh S,et al.Video-assisted thoracoscopic lobectomy vs.conventional lobectomy via open thoracotomy in patients with clinical stage IA non-small-cell lung carcinoma.Interact Cardiovasc Thorac Surg,2007,6 (5):614-617.
22.	Mckenna RJ,Houck W,Fuller CB.Video-assisted thoracic surgery lobectomy:experience with 1,100 cases.Ann Thorac Surg,2006,81 (2):421-426.
23.	王俊,李运,刘军,等.全胸腔镜下肺叶切除治疗早期非小细胞肺癌.中华胸心血管外科杂志,2008,24 (3):147-150.
24.	Watanabe A,Osawa H,Watanabe T,et al.Complications of major lung resections by video-assisted thoracoscopic surgery.Kyobu Geka,2003,56 (11):943-948.
25.	Solli P,Spaggiari L.Indications and developments of video-assisted thoracic surgery in the treatment of lung cancer.Oncologist,2007,12 (10):1205-1214.
26.	杨帆,李晓,任斌辉,等.多中心全胸腔镜肺叶切除手术600例.中华胸心血管外科杂志,2010,26 (5):307-309,293.

1. 姜冠潮,杨帆,王俊.胸腔镜肺叶切除手术治疗非小细胞肺癌新进展.中华胸心血管外科杂志,2010,26 (5):291-293.
2. 蒲强,刘伦旭,马林,等.单向式胸腔镜肺叶切除安全性及技术可行性研究——附1040例报告.四川大学学报:医学版,2013,44 (1):109-113.
3. Aoki T,Tsuchida M,Hashimoto T,et al.Quality of Life after lung cancer surgery:video-assisted thoracic surgery versus thoracotomy.Heart Lung Circ,2007,16 (4):285-289.
4. Tajiri M,Maehara T,Nakayama H,et al.Decreased invasiveness via two methods of thoracoscopic lobectomy for lung cancer,compared with open thoracotomy.Respirology,2007,12 (2):207-211.
5. Nomori H,Horio H,Naruke T,et al.What is the advantage of a thoracoscopic lobectomy over a limited thoracotomy procedure for lung cancer surgery? Ann Thorac Surg,2001,72 (3):879-884.
6. Jemal A,Bray F,Center MM,et al.Global Cancer statistics.CA Cancer J Clin,2011,61 (2):69-90.
7. Siegel R,Naishadham D,Jemal A.Cancer statistics,2013.CA Cancer J Clin,2013,63 (1):11-30.
8. Chen WQ,Zeng HM,Zheng RS,et al.Cancer incidence and mortality in China,2007.Chin J Cancer Res,2012,24 (1):1-8.
9. 翁姗姗,李龙芸,宋伟,等.低剂量螺旋CT对肺内结节的诊断价值.癌症进展,2011,9 (1):7-12.
10. Ettinger DS,Bepler G,Bueno R,et al.Non-small cell lung cancer clinical practice guidelines in oncology.J Natl Compr Canc Netw,2006,4 (6):548-582.
11. Campione A,Ligabue T,Luzzi L,et al.Comparison between segmentectomy and larger resection of stage IA non-small cell lung carcinoma.J Cardiovasc Surg (Torino),2004,45 (1):67-70.
12. Ilonen IK,Räsänen JV,Knuuttila A,et al.Anatomic thoracoscopic lung resection for non-small cell lung cancer in stage I is associated with less morbidity and shorter hospitalization than thoracotomy.Acta Oncol,2011,50 (7):1126-1132.
13. 初向阳,薛志强,刘毅,等.单操作孔电视胸腔镜肺叶切除术治疗早期肺癌的临床研究.中国胸心血管外科临床杂志,2012,19 (2):113-115.
14. Mahtabifard A,Dearmond DT,Fuller CB,et al.Video-assisted thoracoscopic surgery lobectomy for stage I lung cancer.Thorac Surg Clin,2007,17 (2):223-231.
15. 高珂,刘早阳,吴剑,等.单向式全胸腔镜肺叶切除术治疗早期非小细胞肺癌的临床疗效分析.中国胸心血管外科临床杂志,2011,18 (3):231-235.
16. 何建行,刘会平,杨运有.电视胸腔镜肺癌根治术5年临床疗效.中国胸心血管外科临床杂志,2002,9 (1):29-31.
17. Ettinger DS,Akerley W,Borghaei H,et al.Non-small cell lung cancer.J Natl Compr Canc Netw,2012,10 (10):1236-1271.
18. Kim K,Kim HK,Park JS,et al.Video-assisted thoracic surgery lobectomy:single institutional experience with 704 cases.Ann Thorac Surg,2010,89 (6):S2118-S2122.
19. 蒋伟,奚俊杰,王群,等.全胸腔镜肺癌根治术淋巴结清扫的探讨.中国微创外科杂志,2012,12 (11):969-972,975.
20. 李强,何金涛,庄翔,等.电视胸腔镜微创手术与常规肺癌手术淋巴结清扫的对照研究.中国肺癌杂志,2010,13 (12):1141-1144.
21. Sakuraba M,Miyamoto H,Oh S,et al.Video-assisted thoracoscopic lobectomy vs.conventional lobectomy via open thoracotomy in patients with clinical stage IA non-small-cell lung carcinoma.Interact Cardiovasc Thorac Surg,2007,6 (5):614-617.
22. Mckenna RJ,Houck W,Fuller CB.Video-assisted thoracic surgery lobectomy:experience with 1,100 cases.Ann Thorac Surg,2006,81 (2):421-426.
23. 王俊,李运,刘军,等.全胸腔镜下肺叶切除治疗早期非小细胞肺癌.中华胸心血管外科杂志,2008,24 (3):147-150.
24. Watanabe A,Osawa H,Watanabe T,et al.Complications of major lung resections by video-assisted thoracoscopic surgery.Kyobu Geka,2003,56 (11):943-948.
25. Solli P,Spaggiari L.Indications and developments of video-assisted thoracic surgery in the treatment of lung cancer.Oncologist,2007,12 (10):1205-1214.
26. 杨帆,李晓,任斌辉,等.多中心全胸腔镜肺叶切除手术600例.中华胸心血管外科杂志,2010,26 (5):307-309,293.

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Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Short-term Clinical Outcomes of Complete Video-assisted Thoracoscopic Lobectomy for Early-stage Lung Cancer

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