ObjectiveTo investigate the effects of subxiphoid uniportal video-assisted thoracoscopic surgery (SUVATS) and intercostal uniportal VATS (IUVATS) in lobectomy for non-small cell lung cancer (NSCLC).MethodsA total of 428 patients with NSCLC who underwent lobectomy via SUVATS or IUVATS from July 1st to 31st, 2019 in Shanghai Pulmonary Hospital were enrolled. Patient characteristics, perioperative outcomes and postoperative pain scores at different time points were collected. The patients were divided into a SUVATS group (80 patients, 42 males and 38 females with an average age of 58.8±9.6 years) and an IUVATS group (348 patients, 161 males and 187 females, with an average age of 61.2±10.0 years). The clinical effectiveness of the two groups was compared.ResultsThere was no significant difference in sex (P=0.314), age (P=0.052), preoperative pulmonary function (P=0.701), combined chronic comorbidities (chronic cardiovascular disease, P=0.775; chronic obstructive pulmonary disease, P=0.678) and postoperative pathology (P=0.132) between the two groups. Compared with the IUVATS group, patients in the SUVATS group had longer operation time (155.6±34.4 min vs. 141.3±27.0 min, P<0.001), less intraoperative blood loss (165.2±160.6 mL vs. 223.7±272.4 mL, P<0.001), shorter time of chest tube use (4.3±2.0 d vs. 4.9±1.9 d, P=0.011) and less postoperative pain score at different time points (postoperative 8 h, P<0.001; postoperative day 1, P=0.019; postoperative day 2, P=0.015; the day before discharge, P<0.001).ConclusionSUVATS is a safe and effective technique for lobectomy in NSCLC patients with less postoperative pain and can promote postoperative recovery.