Thoracoscopy-assisted mini-incision pulmonary lobectomy / 中国微创外科杂志

ABSTRACT

Objective To compare clinical effects of mini-incision pulmonary lobectomy with or without thoracoscopic assistance. Methods A total of 64 patients, in order of precedence of the operation, were divided into two groups according to a random numbers table. The Group A was given thoracoscopy-assisted mini-incision pulmonary lobectomy while the Group B underwent simple mini-incision lobectomy. Results The length of incision was significantly shorter in the Group A (5.3?0.6 cm) than in the Group B (8.9?0.5 cm) (t=-24.360,P=0.000); the intraoperative blood loss in the Group A (279.7?74.0 ml) was significantly less than that in the Group B (331.7?42.5 ml) (t=-3.330,P=0.002); the drainage volume at the first postoperative day was remarkably less in the Group A (162.5?47.4 ml) than in the Group B (202.0?49.2 ml) (t=-3.220,P=0.002). Complications were noted in 5 patients in the Group A and 11 patients in the Group B (?~2=4.099,P=0.043). The Group A presented a significantly shorter postoperative hospital stay (8.0?2.2 d) than the Group B (9.7?1.9 d) (t=-3.280,P=0.002). There was no statistically significant difference in the operating time between the two groups (t=-1.130,P=0.262). A follow-up observation was carried out in 57 patients for 6~12 months. Local recurrence was observed in 1 patient with stage Ⅲa lung squamous carcinoma at 6 months after operation in the Group A, whereas in the Group B, distant metastasis with local recurrence was found in 2 patients with stage Ⅲa small-cell lung carcinoma and in 1 patient with lung adenocarcinoma at 7~8 months after surgery. All the 4 patients died within 1 year. Three patients ended with other diseases unassociated with the surgery. No local recurrence or distant metastasis was found in the remaining 50 patients. Conclusions As compared with simple mini-incision pulmonary lobectomy, thoracoscopy-assisted mini-incision procedure provides less surgical invasion, fewer complications, and quicker postoperative recovery.