title: Video-assisted thoracic surgery lobectomy versus lobectomy by thoracotomy for lung cancer: pilot study.
abstract: OBJECTIVE
  Video-assisted thoracic surgery lobectomy (VATS-L) has become accepted as a safe and effective procedure to treat early-stage non-small cell lung carcinoma (NSCLC). However, the advantages of VATS-L compared with lobectomy by thoracotomy (TL) remain controversial. The aim of this study was to compare the outcomes of patients who underwent VATS-L with those who underwent TL.
  
  
  METHODS
  We studied 103 patients who underwent surgery for operable NSCLC between October 2009 and March 2012. All operations were performed by a single surgeon. The inclusion and exclusion criteria for VATS-L and TL were formulated before the study was initiated. Data on age, sex, preoperative comorbidities, intraoperative and postoperative complications, hospital stay, morbidity, mortality, and other characteristics were recorded preoperatively, in real time intraoperatively, and during hospitalization and were statistically compared. Comorbidities were scaled according to the Charlson Comorbidity Index, and propensity scores between the patients who underwent TL and VATS-L were compared.
  
  
  RESULTS
  Sixty-three VATS-L operations and 40 TL operations were performed. There were no postoperative complications in 39 patients (61.9%) who underwent VATS-L compared with 25 patients (62.5%) who underwent TL. The patients who underwent TL were significantly younger than the patients who underwent VATS-L (mean ± SD, 64.7 ± 12.6 vs 70.9 ± 8.4; P = 0.003). Hospital stay was not found to be related to the type of surgery (mean ± SD, 8.43 ± 3.15 days vs 8.32 ± 4.13 days; P = 0.888). There were no significant differences when comparing postoperative complications.
  
  
  CONCLUSIONS
  Our initial data suggest that VATS-L is a safe procedure in patients with resectable IA/IB NSCLC and may be the preferred strategy for treatment of the older patient population.
authors.affiliation: Department of Cardiothoracic Surgery, Edith Wolfson Medical Center, Holon, Israel. fredricag@asaf.health.gov.il
authors.forename: Michael
authors.initials: M
authors.lastname: Papiashvilli
authors.forename: Lior
authors.initials: L
authors.lastname: Sasson
authors.forename: Sharbel
authors.initials: S
authors.lastname: Azzam
authors.forename: Henri
authors.initials: H
authors.lastname: Hayat
authors.forename: Letizia
authors.initials: L
authors.lastname: Schreiber
authors.forename: Tiberiu
authors.initials: T
authors.lastname: Ezri
authors.forename: Israel E
authors.initials: IE
authors.lastname: Priel
mesh_terms: D000367:Age Factors; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007902:Length of Stay; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods* / Q000401:mortality; D013908:Thoracotomy / Q000379:methods* / Q000401:mortality; D016896:Treatment Outcome