The Application Of VATS In The Treatment Of Patients With Primary Non-small Cell Lung Cancer

Objective To compare the clinical value of video assist thoracoscopic surgery(VATS) and traditional thoracosopic surgery in the treatment of patients with primary non-small cell cancer(NSCLC).Methods Eighty cases of patients with early stage primary non-small cell lung cancer who were hospitalized from Jan 2013-June 2014 at the department of thoracic surgery in our hospital were selected for the study. They were all confirmed as early peripheral lung cancer by chest CT, CT-guided biopsy or bronchoscopy and other tests, preoperatively. The patients were randomly divided into VATS group (observation group, n=42) and traditional thoracospic lung resection group (control group, n=38). All patients underwent pulmonary lobectomy and systematic lymphadenectomy treatment, and the perioperative indicators, relevant laboratory parameters and quality of life were compared.Results There was no significant difference of age, gender, concomitant diseases, tumor location and diameter, histological type and pathological staging, etc. between the two groups (P>0.05).There was no significant difference of operative time, postoperative WBC, serum pre-albumin and hospital costs between the two groups (P>0.05). Blood loss during operation and postoperative drainage in observation group were significantly less than those in control group(P<0.05). Time of leaving bed after operation in observation group was significantly earlier than that in control group(P<0.05) and postoperative hospital stay was significantly shorter than that in control group(P<0.05). There were no significant differences of number of resected and metastatic lymph node, and the postoperative metastasis and recurrence between the two groups(P<0.05). There were no significant difference of high-sensitivity C-reactive protein (hs-CRP) before surgery between the two groups(P>0.05), whereas the hs-CRP level in both groups was significantly higher after operation than that before operation(P<0.05), and the hs-CRP level after operation in observation group were significantly lower than that in control group(P<0.05). There were no significant difference of lung vital capacity(VC), forced expiratory volume in first second(FEV1), maximal voluntary ventilation(MVV) before operation between the two groups(P>0.05). And the above-mentioned pulmonary parameters in observation group were significant better than those in control group at one and three months after operation(P<0.05). Preoperative quality of life was not statistically different between the two groups, whereas it was significantly promoted after operation in the two groups(P<0.05). The patients’ physiological status and functional status scores in observation group were significantly higher than those in control group (P<0.05).Conclusion VATS lobectomy has similar short-term effect compared with traditional thoracotomy, such as lymph node resection, postoperative recurrence and metastasis. But compared with the latter, VATS lobectomy has many advantages, such as minimally invasive, less injury to pulmonary function, quicker recovery and shorter hospital stay, higher quality of life in the early stage after operation, etc. which can be used as a routine treatment for early stage non-small cell lung cancer.