Clinical value between axillary thoracotomy and video-assisted thoracoscopic lobectomy in the treatment of patients with lung cancer / 中国胸心血管外科临床杂志

ABSTRACT

@#Objective    To compare the subaxillary small incision thoracotomy (SSIT) with video-assisted thoracic surgery (VATS) for patients with lung cancer. Methods    Retrospective analysis of 142 patients with lung cancer in Department of Thoracic Surgery, The First People's Hospital of Neijiang from January 2014 to April 2016 was conducted. There were 86 males and 56 females, aged 40-77 years. Patients were divided into a VATS group (n=72) and a SSIT group (n=70). The following postoperative data were evaluated operation time, number of dissected lymph nodes, intraoperative bleeding, postoperative chest drainage volume, drainage duration, postoperative ambulation time, average hospital stay, postoperative complications, hospitalization cost, early postoperative incision pain (visual analogue scale, VAS) and other indicators. Results    There were no statistically significant differences between the two groups in the operation time (120.8±20.4 min vs. 126.2±21.6 min, P=0.124), the dissected lymph node (11.1±2.0 vs. 11.4±1.9, P=0.333) and the postoperative complications rate (13.9% vs. 15.7%, P=0.759). Laparoscopic intraoperative bleeding and postoperative drainage volume were significantly less in the VATS group than those in the SSIT group (123.2±26.9 ml vs. 156.4±24.0 ml, P<0.001; 227.0±75.5 ml vs. 334.3±89.1 ml, P<0.001). Postoperative drainage duration, postoperative ambulation time and hospital stay were shorter in the VATS group than those in the SSIT group (2.5±0.5 d vs. 3.1±0.6 d, 1.5±0.5 d vs. 2.2±0.6 d, 6.5±0.5 d vs. 7.4±0.6 d, all P<0.001). The average hospitalization cost of the VATS group was significantly higher than that of the SSIT group (42 338.9±8 855.7 yuan vs. 32 043.7±7 178.1 yuan, P<0.001). There was no significant difference in the operation cost and anesthesia cost between the two groups (P>0.05). The early postoperative pain of laparoscopic group was less, but the difference was not statistically significant (P>0.05). Conclusion    The hospitalization cost of the SSIT is lower than that of thoracic surgery, which may be beneficial to the appilication in primary hospitals.