Comparison of perioperative results of conventional versus thoracoscopic lobectomy for clinical stage I lung carcinoma

Background: This study aimed to compare the perioperative results of video-assisted thoracic surgery (VATS) lobectomy with those of conventional lobectomy in patients with clinical stage I non-small cell lung carcinoma (NSCLC). Methods: We began performing VATS lobectomy in our institution in December 2007. The patients with clinical stage I NSCLC who were operated after this date (VATS group, n=20) were compared with the group of patients who were in the same clinical stage and operated via conventional lobectomy (thoracotomy group, n=28) between January and November 2007. Results: The two Groups had similar preoperative characteristics of age, sex, laterality, resected lobe, pulmonary functions. and histological type. The duration of operation was significantly longer in the VATS group than thoracotomy Group (207.5 min versus 142.8 min, p<0.001). The total postoperative chest tube drainage was considerably less in the VATS Group than thoracotomy group (240.5 ml versus 366.6 ml, p=0.01); further, the duration of hospital stay was also shorter in the VATS group than that in the thoracotomy Group (4.88 days versus 6.88 days, p<0.001). The visual analog scale score that defines postoperative pain was significantly better in VATS group (2.15 versus 4.29 p<0.001). The stages of the disease, the complication rates, and the number of lymph node stations sampled during systematic mediastinal sampling were similar in both groups. Conclusion: Video-assisted thoracoscopic lobectomy is a safe and feasible method of treatment for patients with clinical stage I NSCLC. The amount of postoperative drainage is reduced, the duration of hospital stay is shorter and postoperative pain is less with VATS method.