Lymph node evaluation in totally thoracoscopic lobectomy with two‑port for clinical early‑stage nonsmall‑cell lung cancer: Single‑center experience of 1086 cases.

ABSTRACT

OBJECTIVES: Although more and more video‑assisted thoracoscopic surgery (VATS) lobectomies via two‑port have been performed to treat early‑stage nonsmall‑cell lung cancer (NSCLC) in recent years, concern remains whether it can achieve satisfactory adequacy of lymphadenectomy. This retrospective study was aimed to evaluate the adequacy of lymphadenectomy by VATS via two‑port, compared with three‑port. MATERIALS AND METHODS: The clinical and pathological data of patients who underwent VATS lobectomy via two‑port or three‑port with systematic lymphadenectomy for clinical early‑stage NSCLC were reviewed. As the main evaluation criterion, the number of mediastinal nodes and node stations, and the total number of nodes and node stations was compared by approach. RESULTS: 1872 patients with NSCLC underwent VATS lobectomy, 1086 via a two‑port approach and 786 through a three‑port approach. In the two‑port and three‑port groups, the baseline patient characteristics were similar, and there was no significant difference in the mean number of dissected mediastinal lymph nodes (MLNs) (12.3 ± 2.2 and 13.1 ± 1.7, P > 0.05) and the mean number of dissected MLN stations (3.5 ± 0.7 and 3.4 ± 0.8, P > 0.05). Meanwhile, the mean total number of dissected lymph nodes (24.1 ± 4.2 and 25.7 ± 4.3, P > 0.05) and the mean total number of dissected lymph node stations (6.8 ± 1.3 and 6.9 ± 1.1, P > 0.05) were also similar. Otherwise, in terms of postoperative complications, there was no obvious difference in the two groups. CONCLUSIONS: The adequacy of lymphadenectomy including MLN dissection by VATS via two‑port is similar to that via three‑port for patients undergoing lobectomy for clinical early‑stage NSCLC.