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Thorac Cardiovasc Surg 2013; 61(02): 116-123
DOI: 10.1055/s-0031-1299589
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Complete Mediastinal Lymph Node Dissection in Video-Assisted Thoracoscopic Lobectomy Versus Lobectomy by Thoracotomy

Hong Yang
1   Cancer Center, Sun Yat-Sen University, State Key Laboratory of Oncology in Southern China, Guangzhou, P. R. China
,
Xiao-dong Li
1   Cancer Center, Sun Yat-Sen University, State Key Laboratory of Oncology in Southern China, Guangzhou, P. R. China
,
Ren-chun Lai
1   Cancer Center, Sun Yat-Sen University, State Key Laboratory of Oncology in Southern China, Guangzhou, P. R. China
,
Ke-lin She
1   Cancer Center, Sun Yat-Sen University, State Key Laboratory of Oncology in Southern China, Guangzhou, P. R. China
,
Ming-hao Luo
2   Third People’s Hospital of Huizhou, Huizhou, P. R. China
,
Zhen-xuan Li
1   Cancer Center, Sun Yat-Sen University, State Key Laboratory of Oncology in Southern China, Guangzhou, P. R. China
,
Yong-bin Lin
1   Cancer Center, Sun Yat-Sen University, State Key Laboratory of Oncology in Southern China, Guangzhou, P. R. China
› Author Affiliations
Further Information

Publication History

20 October 2011

08 November 2011

Publication Date:
12 March 2012 (online)

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Abstract

Background Although video-assisted thoracic surgery (VATS) lobectomy has been used more and more frequently for the treatment of patients with early-stage lung cancer, controversies are mainly focused on whether the complete mediastinal lymph node dissection (MLND) can be achieved by VATS. This retrospective study aimed to compare the validity of MLND between VATS and open thoracotomy.

Methods Patients with lung cancer were matched from a pool of pulmonary lobectomies performed by one surgeon. Patients undergoing VATS were matched with those undergoing thoracotomy in terms of gender, age, clinical tumor stage, tumor location, and surgical procedure.

Results After matching, 31 patients in VATS group and 31 patients in open group were eligible for analysis. In the VATS and open groups, the mean total number of dissected lymph nodes was 28.2 ± 8.4 and 29.8 ± 11.6 (p = 0.517), respectively. In the VATS and open groups, the number of N1 nodes was 9.5 ± 4.1 and 8.4 ± 4.7 (p = 0.333), respectively. And the number of N2 nodes was also similar between the VATS and open group (18.6 ± 7.0 vs 21.4 ± 10.0, p = 0.211). No significant differences were observed between the two groups in the operating time, the blood loss, the length of chest tube drainage, the length of hospital stay, and the rate of specific complications.

Conclusion Our early experience suggests that, with regard to the number of the dissected lymph nodes, VATS lobectomy can achieve complete MLND, compared with the traditional approach. MLND by VATS is technically feasible and safe for early-stage lung cancer.

Keywords

lung cancer treatment (surgery medical) - minimally invasive surgery (includes port access minithoracotomy) - thoracoscopy/VATS
 

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