Surgical Therapy For Early Non Small Cell Lung Cancer: Vast Vs Thoracotomy
Que K. Do.
Thong Nhat hospital, Ho Chi Minh, Viet Nam.
Objectives: Non Small Cell Lung Cancer (NSCLC) is frequently cancer and the leading cause death of cancer. Lobectomy and lymph node dissection is optimal surgical treatment method for early stage NSCLC. video-assisted thoracic surgery (VATS) approach is less trauma, quickly recovery, whereas those who advocate thoracotomy claim it as an oncologically superior procedure. The aims of study to compare the results of surgical therapy for earlt stage NSCLC by VATS and conventional thoracotomy. Methods: All of patient with NSCLC in stage IA - IIB underwent lobectomy and lymph node dissection through VATS or thoracotomy are collected. Patient characteristics were compared. Operative datas, complications were assessed and survival was assessed by Kaplan-Meier and Cox proportional hazards analysis. Follow-up from 14 to 66 months. Results: From May 2008 to August 2016, 57 patients with NSCLC stage IA - IIB underwent an attempt at VATS lobectomy and 60 patients underwent thoracotomy. There are 75 male and 42 female, mean age is 56.3 range 31 - 84. Lobectomy was performed in 106 cases and bilobectomy in 11 cases. The mean operating time in VATS group is 157 minutes longer than conventional thoracotomy was 124 minutes. No statistic different between 2 group in characteristics of patients. In 57 cases VATS, 5 cases were converted to thoracotomy. There are one patients death in conventional thoracotomy group. One patient had bleeding need to reoperation for controlling bleeding in each group, Prolonged air-leak were 7 cases (10.7%) in thoracotomy and 2 cases (3.8%) in VATS group. Hospitalization is 18.4 days in thoracotomy group and 12.8 days in VATS group. Survival by Cox model was no different for VATS versus thoracotomy (hazard ratio 0.82; P = .21) Conclusion: Video-assisted thoracoscopic surgery is effective and safe method for surgical treatment of early stage NSCLC. Surgery remains the primary therapy in the treatment of early-stage lung cancer. VATS was associated with less complication and shorter length of hospital stay. The 5 year survival is similar in VATS and conventional thoracotomy approach.
Back to 2018 Thoracic Track