title: Analysis of 1,067 cases of video-assisted thoracic surgery lobectomy.
abstract: BACKGROUND
  Video-assisted thoracic surgery (VATS) lobectomy has been performed with increasing frequency over the last decade. However, there is still controversy as to its indications, safety, and feasibility. Especially regarding lung cancer surgery, it is not certain whether it can reduce local recurrences and improve overall survival.
  
  
  METHODS
  We retrospectively reviewed 1,067 cases of VATS lobectomy performed between 2003 and 2009, including the indications, postoperative morbidity, mortality, recurrence, and survival rate.
  
  
  RESULTS
  ONE THOUSAND AND SIXTY SEVEN PATIENTS UNDERWENT VATS LOBECTOMY FOR THE FOLLOWING INDICATIONS: non-small cell lung cancer (NSCLC) (n=832), carcinoid tumors (n=12), metastatic lung cancer (n=48), and benign or other diseases (n=175). There were 63 cases (5.9%) of conversion to open thoracotomy during VATS lobectomy. One hundred thirty one (15.7%) of the 832 NSCLC patients experienced pathologic upstaging postoperatively. The hospital mortality rate was 0.84% (9 patients), and all of them died of acute respiratory distress syndrome. One hundred forty-nine patients (14.0%) experienced postoperative complications. The median follow-up was 22.9 months for patients with NSCLC. During follow-up, 120 patients had a recurrence and 55 patients died. For patients with pathologic stage I, the overall survival rate and disease-free survival rate at 3 years was 92.2±1.5% and 86.2±1.9%, respectively. For patients with pathologic stage II disease, the overall survival rate and disease-free survival rate at 3 years was 79.2±6.5% and 61.9±6.6%, respectively.
  
  
  CONCLUSIONS
  Our results suggest that VATS lobectomy is a technically feasible and safe operation, which can be applied to various lung diseases. In patients with early-stage lung cancer, excellent survival can be also achieved.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea.
authors.forename: Min Suk
authors.initials: MS
authors.lastname: Choi
authors.forename: Joon Suk
authors.initials: JS
authors.lastname: Park
authors.forename: Hong Kwan
authors.initials: HK
authors.lastname: Kim
authors.forename: Yong Soo
authors.initials: YS
authors.lastname: Choi
authors.forename: Jhingook
authors.initials: J
authors.lastname: Kim
authors.forename: Young Mog
authors.initials: YM
authors.lastname: Shim
authors.forename: Kwhanmien
authors.initials: K
authors.lastname: Kim