1996 Volume 10 Issue 5 Pages 587-593
This study compares the outcomes of video-assisted lobectomy and standard lobectomy through open thoracotomy. Forty-six patients with clinical T1N0M0 non-small cell lung cancer were divided into two groups. Twelve patients who were older than 70 years of age underwent video-assisted lobectomy (VATS). Thirty-four patients who were younger than 70 years of age underwent standard lobectomy through an open thoracotomy (OT). There were no differences between the two groups in gender distribution, histology type, tumor grading lymph node metastases, pleural invasion, vascular invasion, or lymphatic vessel invasion. Results : The operation time of the VATS group was significantly longer than that of the OT group (VATS : 5.3 ±-0.2 hours, OT : 4.3 ± 0.1 hours), and the disposable equipment cost of the VATS group was significantly higher than that of the OT group (VATS : 421 ± 48 × 103yen, OT 48 ± 6 × 103yen). Postoperative pain was significantly less in the VATS group compared with the OT group 1 week after surgery. The VATS group had less decrease inforced expiratory volume in 1 sec. 3 months following the surgery than the OT group. There were no differences in intraoperative blood loss, number of resected lymph nodes, duration of fever, duration of chest tube drainage, postoperative leukocyte counts and C-reactive protein concentration or length of postoperative hospital stay between the two groups. There was no significant difference in 3-year survival between the two groups (VATS : 83.3%, OT : 97.1%). Conclusion : VATS successfully reduced postoperative pain but increased disposable equipment costs. The prognosis of patients receiving VATS for T1NOMO lung cancer was similar to that of those receiving standard lobectomy through an open thoracotomy. VATS is a reliable procedure for clinical T1N0M0 lung cancer. Additional long-term studies are needed to determine the efficacy of this procedure.
