Operative outcomes of thoracoscopic lobectomy for non-small-cell lung cancer. (October 2015)

• Record Type: Journal Article
• Authors: Tane, Shinya; Nishio, Wataru; Okuma, Hiromichi; Ogawa, Hiroyuki; Hokka, Daisuke; Tane, Kenta; Tanaka, Yugo; Uchino, Kazuya; Yoshimura, Masahiro; Maniwa, Yoshimasa
• Is Part Of: Asian cardiovascular & thoracic annals. Volume 23:Number 8(2015)
• Page Start: 950
• Page End: 957
• Publication Date: 2015-10
• Subjects: Carcinoma -- non-small-cell lung -- Chemotherapy -- adjuvant -- Lobectomy -- Postoperative complications -- Thoracic surgery -- video-assisted -- Thoracotomy; Heart -- Diseases -- Asia -- Periodicals; Heart -- Diseases -- Pacific Area -- Periodicals; Heart -- Diseases -- Periodicals; Heart -- Surgery -- Asia -- Periodicals; Heart -- Surgery -- Pacific Area -- Periodicals; Heart -- Surgery -- Periodicals; Chest -- Surgery -- Asia -- Periodicals; Chest -- Surgery -- Pacific Area -- Periodicals; Chest -- Surgery -- Periodicals; 617.412
• DOI: 10.1177/0218492315596657
• Languages: English
• ISSNs: 0218-4923

Abstract

Aim: We examined the advantages of thoracoscopy over thoracotomy in terms of perioperative outcomes and toleration of adjuvant chemotherapy. Methods: Between April 2010 and March 2013, 657 patients with non-small-cell lung cancer who underwent lobectomy were classified into thoracoscopy (308 patients) and thoracotomy (349 patients) groups and compared. Results: The thoracoscopy group had less blood loss compared to the thoracotomy group ( p < 0.001). When limiting the analysis to pathological stage I patients, the results were similar ( p < 0.001). In addition, the difference in blood loss between the 2 groups was greater in patients with severe pleural adhesions. The postoperative morbidity of the thoracoscopy group was significantly less than that of the thoracotomy group (13.3% vs. 21.2%, p < 0.001), and this result was similar when analyzing the pathological stage I patients (12.6% vs. 20.6%, p = 0.001). A higher percentage of the thoracoscopy group received both the full planned course and dose of adjuvant chemotherapy compared to the thoracotomy group (84.2% vs. 65.8%, p = 0.032). Conclusions: These results indicate that totally thoracoscopic lobectomy is the more beneficial surgical approach with regard to the incidence of postoperative complications and toleration of adjuvant chemotherapy.