title: [Preliminary comparison research of thoracoscopy and thoracotomy lobectomy for clinical N0 and post-operatively pathological N2 non-small cell lung cancer].
abstract: OBJECTIVE
  To evaluate the safty, thoroughness and efficacy of the video-assisted thoracoscopic surgery  compared with open thoracotomy, in treatment of patients with the preoperative staging of lymph node negative and  postoperative pathological mediastinal lymph node positive (cN0-pN2) locally advanced non-small cell lung  cancer(NSCLC).
  
  
  METHODS
  We performed a retrospective review of 616 patients who underwent either VATS lobectomy  or open thoracotomy from July 2000 to December 2009. Of which 386 patients were diagnosed with preoperative  staging of lymph node negative(cN0) non-small cell lung cancer. Of the 386 patients 76 were diagnosed with  postoperative pathological mediastinal lymph node positive (pN2). Twenty-nine patients were operated by video-assisted thoracoscopic surgery (VATS group), 47 patients were operated by open thoracotomy(T group).The patients' preoperative and intraoperative conditions, postoperative survival and recurrence, etc. were compared.
  
  
  RESULTS
  The two groups were similar in age, gender distribution, pulmonary function, preoperative complications  and the preoperative clinical stage. VATS group was slightly lower than T group in operation time, and blood  loss. The station number of mediastinal lymph nodes dissection was (3.3±1.1) vs. (3.3±1.3), P=0.959; the number  of lymph nodes dissected (12.7±8.9) vs. (10.5±7.2),P=0.260; positive lymph nodes / lymph nodes dissection 28.7%  vs. 32.5%, P=0.592; the postoperative proportion of single-station N2 55.2% vs. 66.0%(P=0.189) in VATS group  and T group, respectively. One, three-year disease-free survival rates after operation in VATS and T group were  82.6% vs.69.2%(P=0.088) and 49.3% vs. 51.3% respectively(P=0.996); one, three-year overall survival rates were  84.9% vs. 71.2%(P=0.149) and 64.0% vs. 42.7% (P=0.121). Both groups had the similar pattern of recurrence, most  of which were distant metastases.
  
  
  CONCLUSIONS
  With respect to the safety,thoroughness and recent effect, VATS  is not inferior to open thoracotomy in the treatment of cN0-pN2 non-small cell lung cancer.
authors.affiliation: Department of Thoracic Surgery, Peking University People's Hospital, Being 100044, China.
authors.forename: Feng-wei
authors.initials: FW
authors.lastname: Li
authors.forename: Guan-chao
authors.initials: GC
authors.lastname: Jiang
authors.forename: Yun
authors.initials: Y
authors.lastname: Li
authors.forename: Liang
authors.initials: L
authors.lastname: Bu
authors.forename: Fan
authors.initials: F
authors.lastname: Yang
authors.forename: Jian-feng
authors.initials: JF
authors.lastname: Li
authors.forename: Hui
authors.initials: H
authors.lastname: Zhao
authors.forename: Yan-guo
authors.initials: YG
authors.lastname: Liu
authors.forename: Zu-li
authors.initials: ZL
authors.lastname: Zhou
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008197:Lymph Node Excision / Q000379:methods; D008207:Lymphatic Metastasis; D008297:Male; D008482:Mediastinum; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods*; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D013908:Thoracotomy