[Comparison of the short-term outcomes of surgical treatment for non-small cell lung cancer via video assisted thoracoscopic surgery and open thoracotomy].
OBJECTIVE
To compare the short-term outcomes of surgical treatment for non-small cell lung cancer (NSCLC) by video-assisted thoracoscopic surgery (VATS) and open thoracotomy (OT).


METHODS
Data of 737 consecutive NSCLC patients who underwent surgical treatment for non-small cell lung cancer by video-assisted thoracoscopic surgery and 630 patients who underwent pulmonary resection via open thoracotomy (as controls) in Cancer Institute & Hospital, Chinese Academy of Medical Sciences between January 2009 and August 2011 were retrospectively reviewed. The risk factors after lobectomy were also analyzed.


RESULTS
In the 506 NSCLC patients who received VATS lobectomy, postoperative complications occurred in 13 patients (2.6%) and one patient died of acute respiratory distress syndrome (0.2%). In the 521 patients who received open thoracotomy (OT) lobectomy, postoperative complications occurred in 21 patients (4.0%) and one patient died of pulmonary infection (0.2%). There was no significant difference in the morbidity rate (P > 0.05) and mortality rate (P > 0.05) between the VATS group and OT group. In the 190 patients who received VATS wedge resections, postoperative complications occurred in 3 patients (1.6%). One hundred and nine patients received OT wedge resections. Postoperative complications occurred in 4 patients (3.7%). There were no significant differences for morbidity rate (P = 0.262) between these two groups, and there was no perioperative death in these two groups. Univariate and multivariate analyses demonstrated that age (OR = 1.047, 95%CI: 1.004 - 1.091), history of smoking (OR = 6.374, 95%CI: 2.588 - 15.695) and operation time (OR = 1.418, 95%CI: 1.075 - 1.871) were independent risk factors of postoperative complications.


CONCLUSIONS
To compare with the NSCLC patients who should undergo lobectomy or wedge resection via open thoracotomy, a similar short-term outcome can be achieved via VATS approach.
Department of Thoracic Surgical Oncology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Ju-wei
JW
Mu
Bai-hua
BH
Zhang
Ning
N
Li
Fang
F
Lü
You-sheng
YS
Mao
Qi
Q
Xue
Shu-geng
SG
Gao
Jun
J
Zhao
Da-li
DL
Wang
Zhi-shan
ZS
Li
Yu-shun
YS
Gao
Liang-ze
LZ
Zhang
Jin-feng
JF
Huang
Kang
K
Shao
Fei-yue
FY
Feng
Liang
L
Zhao
Jian
J
Li
Gui-yu
GY
Cheng
Ke-lin
KL
Sun
Jie
J
He
D000367:Age Factors; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011013:Pneumonectomy / Q000009:adverse effects / Q000145:classification / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology; D012128:Respiratory Distress Syndrome / Q000209:etiology; D012189:Retrospective Studies; D012907:Smoking; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects; D013908:Thoracotomy / Q000009:adverse effects / Q000379:methods