title: Operative outcomes of thoracoscopic lobectomy for non-small-cell lung cancer.
abstract: OBJECTIVE
  We examined the advantages of thoracoscopy over thoracotomy in terms of perioperative outcomes and toleration of adjuvant chemotherapy.
  
  
  METHODS
  Between April 2010 and March 2013, 657 patients with non-small-cell lung cancer who underwent lobectomy were classified into thoracoscopy (308 patients) and thoracotomy (349 patients) groups and compared.
  
  
  RESULTS
  The thoracoscopy group had less blood loss compared to the thoracotomy group (p < 0.001). When limiting the analysis to pathological stage I patients, the results were similar (p < 0.001). In addition, the difference in blood loss between the 2 groups was greater in patients with severe pleural adhesions. The postoperative morbidity of the thoracoscopy group was significantly less than that of the thoracotomy group (13.3% vs. 21.2%, p < 0.001), and this result was similar when analyzing the pathological stage I patients (12.6% vs. 20.6%, p = 0.001). A higher percentage of the thoracoscopy group received both the full planned course and dose of adjuvant chemotherapy compared to the thoracotomy group (84.2% vs. 65.8%, p = 0.032).
  
  
  CONCLUSIONS
  These results indicate that totally thoracoscopic lobectomy is the more beneficial surgical approach with regard to the incidence of postoperative complications and toleration of adjuvant chemotherapy.
authors.affiliation: Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan stane@med.kobe-u.ac.jp.
authors.forename: Shinya
authors.initials: S
authors.lastname: Tane
authors.affiliation: Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Nishio
authors.affiliation: Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Okuma
authors.affiliation: Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ogawa
authors.affiliation: Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hokka
authors.affiliation: Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan.
authors.forename: Kenta
authors.initials: K
authors.lastname: Tane
authors.affiliation: Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Yugo
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Uchino
authors.affiliation: Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yoshimura
authors.affiliation: Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Maniwa
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D007564:Japan; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D012307:Risk Factors; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects; D013908:Thoracotomy / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
keywords: Carcinoma; Chemotherapy; Lobectomy; Postoperative complications; Thoracic surgery; Thoracotomy; adjuvant; non-small-cell lung; video-assisted