Comparison of outcomes between muscle-sparing thoracotomy and video-assisted thoracic surgery in patients with cT1 N0 M0 lung cancer

作者：Zhao, Yue; Li, Guodong; Zhang, Yang; Hu, Hong; Zhang, Jie; Sun, Yihua; Chen, Haiquan^*

来源：The Journal of Thoracic and Cardiovascular Surgery, 2017, 154(4): 1420-+.

DOI：10.1016/j.jtcvs.2017.04.071

• muscle-sparing thoracotomy
• video-assisted thoracic surgery
• lung cancer

Objective: To compare short-term complications and long-term survival outcomes between muscle-sparing thoracotomy (MST) and video-assisted thoracic surgery (VATS) groups using a propensity-score matching process. @@@ Methods: One thousand eighty-three patients with cT1 N0 M0 lung cancer from January 2009 to December 2014 who underwent lobectomy and a systematic lymph node dissection were retrospectively included, and statistical analyses including a propensity-score matching process were used to compare shortterm and long-term outcomes. @@@ Results: Before propensity-score matching, for short-term surgical outcomes, the VATS group had fewer chest tube dwelling days (P<.001), less chest tube output (P<.001), shorter hospital stay, and fewer postoperative complications (P = .015). For long-term survival outcomes, the VATS group had a longer recurrence-free survival (P<.001) and overall survival (P<.001). After propensity-score matching, for short-term surgical outcomes, the VATS group had fewer chest tube dwelling days (P<.001), less chest tube output (P<.001), shorter hospital stay (P = .002), and fewer postoperative complications (P = .008). There was no difference in recurrence-free survival and overall survival between the 2 groups (P = .158 and P = .639, respectively). @@@ Conclusions: VATS is less invasive and is associated with shorter length of hospital stay and fewer postoperative complications. The 2 surgical approaches have equivalent long-term survival outcomes.

• 出版日期2017-10
• 单位复旦大学