WEI Ruishi 1,2 , ZHUANG Xiaofei 3 , GUO Shiping 3 , YU Jianrong 2 , LI Xinhua 1
  • 1. Department of Thoracic Surgery, The Second Hospital of Shanxi Medical University, Taiyuan, 030001, P.R.China;
  • 2. Department of Thoracic Surgery, Changzhou Cancer Hospital Affiliated to Soochow University, Changzhou, 213001, Jiangsu, P.R.China;
  • 3. Department of Thoracic Surgery, Shanxi Cancer Hospital, Taiyuan, 030013, P.R.China;
YU Jianrong, Email: 390023627@qq.com; LI Xinhua, Email: kunkung_001@163.com
Central non-small cell lung cancer; total thoracoscopy; thoracotomy; sleeve resection; lobectomy
10.7507/1007-4848.202004077
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Objective To evaluate the efficacy of video-assisted thoracoscopic sleeve lobectomy in the treatment of central non-small cell lung cancer.Methods The clinical data of 105 patients with central non-small cell lung cancer who underwent sleeve lobectomy surgery in the Second Hospital of Shanxi Medical University and Shanxi Cancer Hospital from December 2014 to December 2019 were retrospectively analyzed, including 83 males and 22 females, with an average age of 57.4 (32.6-77.8) years and weight of 62.5 (52.4-79.1) kg. Thirty-five patients received video-assisted thoracoscopic sleeve lobectomy (a group A), and 70 patients received traditional thoracotomy sleeve lobectomy (a group B). The operation time, intraoperative blood loss, number of lymph node dissection, postoperative complication rate, early postoperative mortality, total thoracic drainage volume at 24 hours, time of indwelling chest tube after operation, pain score at 24 hours after operation, postoperative hospital stay, postoperative short-term (1 month, 6 months and 1 year) quality of life score and postoperative 3-year survival rate of two groups were compared.Results There was statistical difference in the operation time (228.1±24.7 min vs. 175.0±23.7 min, P=0.02), postoperative complication rate (28.6% vs. 34.3%, P=0.04), postoperative pain score at 24 h (3.6±3.5 points vs. 5.9±2.0 points, P=0.03) and postoperative indwelling chest tube time (5.0±2.9 d vs. 8.4±2.1 d, P=0.04) between the two groups. There was no statistical difference in the intraoperative blood loss (182.5±36.9 mL vs. 189.8±27.5 mL, P=0.34), number of lymph node dissections (11.1±2.6 vs. 12.3±1.9, P=0.49), early postoperative mortality (2.9% vs. 4.3%, P=0.31), total thoracic drainage volume at 24 h after surgery (346.8±91.1 mL vs. 329.8±101.4 mL, P=0.27), postoperative hospital stay (7.9±4.2 d vs. 8.5±3.4 d, P=0.39) and 3-year postoperative survival rate (68.6% vs. 72.9%, P=0.82) between the two groups.Conclusion Video-assisted thoracoscopic sleeve lobectomy for the treatment of central non-small cell lung cancer is safe and feasible. Compared with traditional thoracotomy for sleeve lobectomy, fewer postoperative complications occur, body recovers faster and the quality of life is higher within the postoperative 6 months. Besides, the 3-year survival rate can achieve similar oncological prognosis results.

Citation： WEI Ruishi, ZHUANG Xiaofei, GUO Shiping, YU Jianrong, LI Xinhua. Video-assisted thoracoscopic sleeve lobectomy in the treatment of central non-small cell lung cancer: A retrospective cohort study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(6): 720-724. doi: 10.7507/1007-4848.202004077 Copy

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