Video-assisted thoracic surgery (VATS) compares favorably with thoracotomy for the treatment of lung cancer: a five-year outcome comparison.

BACKGROUND: Although video-assisted thoracic surgery (VATS) lobectomy has been demonstrated to be safe and technically feasible, it is infrequently performed in most Chinese hospitals and few thoracic surgeons have performed the operation. We have therefore reviewed our experience with all VATS lobectomies, attempting to define long- and short-term outcomes of these surgeries.

METHODS: We retrospectively analyzed the results in patients who underwent VATS lobectomy and open lobectomy between March 1996 and August 2003. The VATS surgery was performed with the endoscopic hilar dissection technique. Perioperative data were collected and long-term outcomes were assessed by 5-year census.

RESULTS: We successfully performed VATS procedures in 113 of 120 patients. The median operative time was 152 min and the median hospitalization was 8.6 days. The median operative blood loss was 130 ml and the median drainage time was 3.5 days. The operative and perioperative (30-day) mortality rates were 0% and 0.9%, respectively; the postoperative complications rate was 10.6%. The 5-year overall survival rates for stage I, stage II, and stage III or greater non-small cell lung cancer (NSCLC), secondary pulmonary malignancy, and benign disease were 79.1%, 45.5%, 22.2%, 33.3%, and 88.6%, respectively.

CONCLUSIONS: Video-assisted lobectomy is a safe and feasible surgical procedure, and it gives the same long-term results as conventional open lobectomy. The VATS approach to lobectomy is a beneficial alternative to standard thoracotomy for selected cases of pulmonary lesions.