Curative Effects of Different Sequences of Vessel Interruption During the Completely Thoracoscopic Lobectomy on Early Stage Non-Small Cell Lung Cancer.
OBJECTIVE
To study the correlation between prognosis and different sequences of pulmonary artery and vein interruption during completely thoracoscopic lobectomy for early stage non-small cell lung cancer.


METHODS
Retrospective analysis of 334 cases underwent completely thoracoscopic lobectomy, which were identified as stage I~II non-small cell lung cancer by pathology. They were divided into three groups according to the order of vessel interruption: pulmonary vein first (Group V, n = 174), pulmonary artery first (Group A, n = 93), and artery-vein-artery group (Group M, n = 67). Their preoperative and operative conditions, and the postoperative survival, recurrence were compared.


RESULTS
Group A had less cases with history of smoking but more with history of pulmonary infection. The average bleeding amount during the operation in Group A is significantly less Group V, and Group M fell in between them. The duration of operation and postoperative complications were similar among the three groups. The types of tumor recurrence were also similar, which were mostly distant metastasis. There was no statistically significant difference in tumor-free survival and overall survival among the three groups.


CONCLUSIONS
For the treatment of stage I~II non-small cell lung cancer using completely thoracoscopic lobectomy, pulmonary artery interruption first can reduce the bleeding amount without affecting the operative difficulty and postoperative complications. The sequence of vessel interruption during lobectomy by thoracoscopic surgery would not affect tumor recurrence, metastasis and survival.
Department of Thoracic Surgery, People's hospital of Peking University, Beijing, China.
Fengwei
F
Li
Guanchao
G
Jiang
Yingtai
Y
Chen
Jun
J
Wang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006470:Hemorrhage; D006801:Humans; D007431:Intraoperative Complications; D008168:Lung / Q000601:surgery*; D008171:Lung Diseases / Q000150:complications; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D061646:Operative Time; D011183:Postoperative Complications; D011651:Pulmonary Artery / Q000601:surgery*; D011667:Pulmonary Veins / Q000601:surgery*; D012189:Retrospective Studies; D012907:Smoking; D013906:Thoracoscopy