The Clinical Analysis Of Video-assisted Thoracoscopic Surgery, Video-assisted Mini-thoracotomy And Traditionl Surgicaltreatmenton The Clinical N₀and Post-operatively Pathological N2Non-small Cell Lung Canc Er

[Objective]By comparing the VATS, VAMT and traditional surgery CN0-PN2non-small cell lung cancer the clinical data of mediastinal lymph nodedissection.Investigate mediastinal lymph node dissection Feasibility Of thetreatment technique of thoracoscopic with the preoperative staging oflymphnode negative and postoperative pathological mediastinal lymph nodepositive(cN0-pN2)non-small cell lung cancer.[Methods]retrospective study:We performed a retrospective review of296patients who underwent the VATS lobectomy,the vamt lobectomy and openthoracotomy from may2004tojune2010. Who was diagnosed withpreoperative staging of lymph node negative (cN0) non-smallcell lungcancer． Of the296patients vats was153patients.vamt was88patients.conventional thoracotomy was55patients.The patients who were diagnosed with preoperative staging of lymph node negative (cN0) non-smallcell lung cancer were sixty-two.of which vats was28patients.vamt was22patients， conventional thoracotomy WAs14patients.The comparativeanalysis of three groups of patients of preoperative clinical data, the number ofmediastinal lymph node dissection group, the total number of positive lymphnodes and positive nodes proportion.Prospectie study:24cases were more detailed design case of selectedconditions, comparison and analysis of the three kinds of operation method ineach region of the lymph node dissection of the total number, mediastinum,lymph node dissection, regional lymph node dissection of the number andproportion of positive lymph node, to verify the results were retrospectivelyanalyzed.[Results]Retrospective study:The clinical material of296casespatients of CNOwere reviewed, one hundred thirty-three patients were taken by vats，88patients were taken by vamt and55patientswere taken by conventionalthoracotomy.62patients of postoperative pathological lymph node-positive.including28patients of VATS,22patients of VAMT and14patients oftraditional thoracotomy surgery,The three groups were similar in age、genderdistribution，Tumor location，clinical stage and the type of cases.The cN0-PN2patients accounted for the cN0ratio in the three surgical methods were18.3%、22.7%、25.4%.The statistical analysis no significant difference.thelymphadenectomy numberOf VATS VAMT and traditional surgery were11.89±5.31,13.85±6.60,10.57±3.37(P=0.211) group number of Lymphnode dissection:VATS was4.32±0.91;VAMT was4.20±0.95; conventionalthoracotomy was4.35±0.89(P=.353). Positive lymph node number:VATSWAS2.82±1.98;VAMT was2.55±1.66; conventional thoracotomy was3.14±1.406P=0.631.Lymph node metastasis rates were23.7%,18.4%,29.7%P=1.000. the mean post operative drainage volume and Thepostoperative drainage time was similar. prospective study:The clinical material of24casespatients of CNO werereviewed, Fifteen patients were taken by vats，8patients were taken by vamtand5patients were taken by conventional thoracotomy.The three groups weresimilar in age，gender distribution，Tumor location, clinical stage. the type ofcases.the lymphadenectomy number: VATS was11.89+5.31;VAMT was13.85+6.60;Traditional surgery was10.57±3.37(P=0.226).group number ofLymph node dissection:vATS was4.32±0.91;VAMT was5.25±0.88;conventional thoracotomy was4.80±0.44(P=0.203).Positive lymph nodenumber:VATS was2.82±0.98;VAMT was2.50±0.53;Conventionalthoracotomy was3.00±1.00P=0.569.The results was similar with theretrospective studies.Postoperative drainage among the three groups p=0.005, P<0.01.Two independent samples show that the VATS group and thethe VAMT group was statistically no significant difference P=0.663(P>0.05);in VATS group and OPEN groups statistically significant difference P=0.03(P <0.05);VAMT and OPEN group statistically significant difference P=0.02(p <0.05).Conclusion:Thoracoscopic operation for treatment of CNO-PN2non smallcell lung cancer with traditional operation as complete mediastinal lymph nodedissection.