Bilgi Zeynep, Batırel Hasan Fevzi, Yıldızeli Bedrettin, Bostancı Korkut, Laçin Tunç, Yüksel Mustafa
Department of Thoracic Surgery, Kars Harakani State Hospital.
Department of Thoracic Surgery, Marmara University Faculty of Medicine.
Korean J Thorac Cardiovasc Surg. 2017 Aug;50(4):275-280. doi: 10.5090/kjtcs.2017.50.4.275. Epub 2017 Aug 5.
Video-assisted thoracoscopic surgery (VATS) anatomic lung resections are gradually becoming the standard surgical approach in early-stage non-small cell lung cancer (NSCLC). The technique is being applied in cases of larger tumors depending on the experience of the surgical team. The objective of this study was to compare early surgical and survival outcomes in patients undergoing anatomic pulmonary resections using VATS and thoracotomy techniques for clinical T2 NSCLC during the adaptation period of the surgical team to the VATS approach.
The data of all patients who underwent anatomic pulmonary resection for NSCLC using VATS and open techniques since April 2012 were recorded to create a prospective lung cancer database. Clinical T2 NSCLC patients who underwent VATS anatomic lung resection were identified and compared with cT2 patients who underwent open resection.
Between April 2012 and August 2014, 269 anatomical resections for NSCLC were performed (80 VATS and 189 thoracotomy). Thirty-four VATS patients who had clinical T2 disease were identified and stage-matched to thoracotomy patients. The average tumor diameter was comparable (34.2±11.1×29.8±10.1 mm vs. 32.3±9.8×32.5±12.2 mm, p=0.4). Major complications were higher in the thoracotomy group (n=0 vs. n=5, p=0.053). There was no 30-day mortality, and the 2-year survival rate was 91% for VATS and 82% for thoracotomy patients (p=0.4).
VATS anatomic resections in clinical T2 NSCLC tumors are safe and have perioperative and pathologic outcomes similar to those of thoracotomy, while remaining within the learning curve.
电视辅助胸腔镜手术（VATS）解剖性肺切除术正逐渐成为早期非小细胞肺癌（NSCLC）的标准手术方式。根据手术团队的经验，该技术也应用于更大肿瘤的病例。本研究的目的是在手术团队适应VATS方法的适应期，比较采用VATS和开胸技术对临床T2期NSCLC患者进行解剖性肺切除的早期手术和生存结果。
记录自2012年4月以来所有采用VATS和开放技术进行NSCLC解剖性肺切除患者的数据，以建立前瞻性肺癌数据库。确定接受VATS解剖性肺切除的临床T2期NSCLC患者，并与接受开放切除的cT2患者进行比较。
2012年4月至2014年8月，共进行了269例NSCLC解剖性切除（80例VATS和189例开胸手术）。确定了34例患有临床T2期疾病的VATS患者，并与开胸手术患者进行分期匹配。平均肿瘤直径相当（34.2±11.1×29.8±10.1mm对32.3±9.8×32.5±12.2mm，p = 0.4）。开胸手术组的主要并发症更高（n = 0对n = 5，p = 0.053）。无30天死亡率，VATS患者的2年生存率为91%，开胸手术患者为82%（p = 0.4）。
临床T2期NSCLC肿瘤的VATS解剖性切除是安全的，围手术期和病理结果与开胸手术相似，且仍处于学习曲线范围内。
