Comparison Of Thoracoscope Surgery With Open Thoracic Surgery In Patients With ?a-N2 Non-small-cell Lung Cancer Underwent Neoadjuvant Chemotherapy

Objective: To investigate the safety and feasibility of thoracoscople lobe resection in patients with clinical stage ?a-N2 non-small-cell lung cancer(NSCLC)underwent neoadjuvant chemotherapy.Methods From June 2012 to June 2016,40 cases with clinical staging ?a-N2 NSCLC received neoadjuvant chemotherapy and lung resection.The patients were randomly divided into two groups,VATS group(20 cases): received VATS lobectomy plus systematic mediastinal lymph nodes dissection;Control group(20 cases): traditional thoracotomy lobectomy plus systematic mediastinal lymph nodes dissection were performed.operation time,intraoperative blood loss,drainage tube indwelling time,number of lymph node cleaning,postoperative complications,postoperative hospitalization days,postoperative pain VAS score of the two groups were compared.Results 17 cases in VATS group received thoracoscople lung resection.1 case(1/20,5 %)line suture surgical exploration,turned to open chest lung resection in 2 cases(2/20,%);Traditional thoracotomy group of 20 patients were successfully completed lung resection.Two groups of patients with no perioperative death.Operation time,VATS group165.47±30.54 min,Traditional thoracotomy group 152.53±35.65.Intraoperative blood loss: VATS group 187.35±90.93 m L,Traditional thoracotomy group 210.29 ± 98.02 mL.Drainage tube indwelling time: VATS group 5.42±2.49 days,Traditional thoracotomy group 5.35± 3.18 days.Number of lymph node cleaning: VATS group 9.59 ±2.32,Traditional thoracotomy group 9.47±2.03.Postoperative complications: VATS group in 2 cases(11.8%)and control group in 6 cases(30.0%).Postoperative hospitalization days: VATS group 7.35± 2.03 days,control group 10.12±2.32 days.Compared with the control groups,no statistically significant difference were found in operation time,intraoperative blood loss,drainage tube indwelling time,the number of lymph node sampled.The VATS group got less incidence of postoperative complications and lower VAS pain score,shorter hospitalization days.Conclusion VATS lobectomy surgery in clinical staging ?a-N2 NSCLC underwent neoadjuvant chemotherapy is safe and feasible.