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KMID : 0364020090420050615
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Korean Journal of Thoracic and Cardiovascular Surgery
2009 Volume.42 No. 5 p.615 ~ p.623
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Video-Assisted Thoracic Surgery Lobectomy for Non-Small Cell Lung Cancer: Experience of 133 Cases
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Kim Hyeong-Ryul
Cho Jeong-Su
Jang Hee-Jin
Lee Sang-Cheol
Choi Eun-Suk
Jheon Sang-Hoon
Sung Sook-Whan
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Abstract
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Background: We evaluated the feasibility and the efficacy of Video-Assisted Thoracic Surgery (VATS) lobectomy for treating patients with non-small cell lung cancer (NSCLC) and we compared the outcomes of VATS lobectomy with those of open lobectomy.
Material and Method: From 2003 to March 2008, 133 NSCLC patients underwent VATS lobectomy. The patients were selected on the basis of having clinical stage I disease on the chest CT and PET scan. The outcomes of 202 patients who underwent open lobectomy (OL group) for clinical stage I NSCLC were evaluated to compare their results with those of the patients who underwent VATS lobectomy (the VL group).
Result: The number of females and the number of patients with adenocarcinoma and stage IA disease were greater in VL group (p＜0.05). There was no operative mortality or major complications in the VL group. Conversion to thoracotomy was needed in 8 cases (6%), which was mostly due to bleeding. The chest tube indwelling time and the length of the postoperative hospital stay were significantly shorter in the VL group (p＜0.001). The number of dissected lymph nodes and the size of tumor were significantly smaller in the VL group (p＜0.001). For the pathologic stage I patients, there was no significant difference in the three-year survival rates between the two groups (p=0.15).
Conclusion: VATS lobectomy is a safe procedure with low operative mortality and morbidity. VATS lobectomy is feasible for early stage NSCLC and it provides outcomes that are comparable to those for open lobectomy. Further long-term data are needed.
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KEYWORD
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Video-assisted thoracoscopy, Lobectomy, Carcinoma, non-small cell, lung
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