The study of the correlation between prognosis and the sequence of vessel interruption during thoracoscopic lobectomy for early stage non-small cell lung cancer / 中华胸心血管外科杂志

ABSTRACT

Objective To study the correlation between prognosis and the sequence of vessel interruption during thoracoscopic lobectomy for early stage non-small cell lung cancer.Methods Retrospective analysis of the 1 134 cases underwent lobectomy between September 2006 and October 2012 was conducted.There were 277 cases underwent completely thoracoscopic lobectomy and confirmed as stage Ⅰ-Ⅱ non-small cell lung cancer by pathology.The cases were divided into three groups according to the vessel interruption sequencepulmonary vein ligated first(Group V) 152 cases,pulmonary artery ligated first (Group A) 76 cases,and artery-vein-artery group(Group M) 49 cases.The preoperative condition,operative factors and the prognosis of the three groups were reviewed.All of the data for statistical analysis,count data by chi-square test.Measurement data using t test,Kaplan-Meier method applied survival analysis,Log-rank test and Cox regression model analysis for single factor and multiple factors.Results The groups were similar in age,sex,smoking history,pulmonary infection history,main comorbidity,malignant history,diameter,tumor maker and preoperative lung function.The blood loss during the operation is 109.9 ml in Group A,which is significantly less than Group V (157.5 ml),and Group M had the median blood loss 123.7 ml (P =0.027).The length of operation and postoperative complications were similar among the three groups.The recurrent conditions were also similar among the three groups,which were mostly distant metastasis.There was no significant difference statistically in disease free survival(DFS) and overall survival(OS) among the three groups.Conclusion Ligating the pulmonary artery first could decrease the blood loss during completely thoracoscopic lobectomy for stage Ⅰ-Ⅱ non-small cell lung cancer.But it did not have any influence on the surgical difficulty and postoperative complications.The sequence of vessel interruption during lobectomy by thoracoscopic surgery did not have difference effect on the prognosis of lung cancer.