Clinical Significance of Lymph Node inside Lung Dissection of Non-small Cell Lung Cancer in Stage T<sub>1</sub>_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANGHai ^1,2 , WUHao ¹ , MUZhi-min ¹ , XIEYuan-cai ¹ , MAOGuang-xian ¹ , MEIShan-shan ¹ , WUDa ¹ ,  LIUJi-xian ¹

1. Department of Thoracic Surgery, Shenzhen Hospital, Peking University, Shenzhen 518036 Guangdong, P.R.China;
2. School of Medicine,Shantou University, Shantou 515041 Guangdong, P.R.China;

Corresponding author：

LIUJi-xian, Email: LJX_doctor@tom.com

Keywords：

Uniportal; Video-assisted thoracoscopic operation; Lung cancer

DOI：

10.7507/1007-4848.20160080

Video：

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Objective To investigate the feasibility and safety of uniportal video-assisted thoracic surgery (VATS) for primary lung cancer. Methods We retrospectively analyzed the clinical data of 95 primary lung cancer patients in our hospital between January 2014 and January 2015. The patients were divided into an observation group (45 patients) and a control group (50 patients). Standard thoracoscopy lobectomy was used in the control group. Uniportal thoracoscopy lobectomy was used in the trial group. The parameters of the two groups were observed. Results The surgeries of the two groups were successfully completed. There was no statistical difference in operative time, intraoperative transit rate, blood loss, number of lymph node dissection, thoracic drainage and pathology Ⅰ, Ⅱ period (P>0.05). Postoperative drainage tube time, postoperative hospital stay, postoperative pain in the observation group were better than those in the control group (P<0.05). But postoperative drainage time in the observation group was longer than that in the control group (P<0.05). Also, the total hospital costs, especially on the use of expensive consumables, during surgery in the observation group was higher. And there was a higher risk of delayed incision healing or airway injury (P<0.05) in the observation group. One death in the control group during perioperative period occurred. Conclusion Uniportal VATS operation applied in radical operation for lung cancer is safe and feasible. It accelerates postoperative turnover, reduces postoperative pain. But there is a higher risk for airway injury or delayed wound healing, and an increase in use of medical consumptive stuff.

Citation： ZHANGHai, WUHao, MUZhi-min, XIEYuan-cai, MAOGuang-xian, MEIShan-shan, WUDa, LIUJi-xian. Clinical Significance of Lymph Node inside Lung Dissection of Non-small Cell Lung Cancer in Stage T₁. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(4): 346-351. doi: 10.7507/1007-4848.20160080 Copy

1.	牟国卫, 刘伦旭. 单孔电视胸腔镜手术临床应用的现状与进展. 中国胸心血管外科临床杂志, 2012, 19(2): 181-184.
2.	Jutley RS, Khalil MW, Rocco G. Uniportal vs standard three—port VATS technique for spontaneous pneumothorax: comparison of postoperative pain and residual paraesthesia. Eur J Cardiothorac Surg, 2005, 28 (1): 43-46.
3.	Gaetano R, Nicola M, Carmine LM, et al. Ten-year experience on 644 patients undergoing single-port (Uniportal) video-assisted thoracoscopic surgery. Ann Thorac Surg, 2013, 96(2): 434-438.
4.	Gonzalez-Rivas D, de la Torre M, Fernandez R, et al. Single-port video-assisted thoracoscopic left upper lobectomy. Interact Cardiovasc Thorac Surg, 2011, 13(5): 539-554.
5.	Gonzalez-Rivas D, Paradela M, Garcia J, et al. Single-port video-assisted thoracoscopic lobectomy. Interact Cardiovasc Thorac Surg, 2011, 12(3): 514-515.
6.	Gonzalez-Rivas D, Paradela M, Fernandez R, et al. Uniportal video-assisted thoracoscopic lobectomy: two years of experience. Ann Thorac Surg, 2013, 95(2): 426-432.
7.	Gonzalez-Rivas D, de la Torre M, Femandez R, et al. Single-incision video-assisted thoracoscopic right pneumonectomy. Surg Endosc, 2012, 26(7): 2078-2079.
8.	Licht PB, Jorgensen OD, Ladegaard L, et al. A national study of nodal upstaging after thoracoscopic versus open lobectomy for clinical stage I lung cancer. Ann Thorac Sur, 2013, 25(23): 1l02-1107.
9.	Gonzalez-Rivas D, Fieira E, Delgado M, et al. Is uniportal thoracoscopic surgery a feasible approach for advanced stages of non-small cell lung cancer? J Thorac Dis, 2014, 6(6): 641-648.
10.	Non-small cell lung cancer version 4，2014，NCCN Clinical Practice Guidelines in Oncology. Available from: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp#nscl, 2015-10-12.
11.	Lin Z, Xu S, Wang Q. Uniportal video-assisted thoracoscopic surgery right upper lobectomy with systematic lymphadenectomy in a semiprone position. J Thorac Dis, 2014, 6(12): 1840-1842.
12.	Chung JH, Choi YS, Cho JH, et al. Uniportal video-assisted thoracoscopic lobectomy: an alternative to conventional thoracoscopic lobectomy in lung cancer surgery? Interact Cardiovasc Thorac Surg, 2015, 20(6): 813-819.
13.	Puri V, Meyers BF. Video-assisted thoracoscopic surgery lobectomy for lung cancer. Surg Oncol Clin N Am, 2013, 22 (1): 27-38.
14.	Fieira Costa E, Delgado Roel M, Paradela M, et al. Technique of uniportal VATS major pulmonary resections. J Thorac Dis, 2014, 6(Suppl 6): S660-S664.
15.	McElnay PJ, Molyneux M, Krishnadas R, et al. Pain and recovery are comparable after either uniportal or multiport video-assisted thoracoscopic lobectomy: an observation study. Eur J Cardiothorac Surg, 2015, 47(5): 912-915.
16.	Fernández Prado R, Fieira Costa E, Delgado Roel M, et al. Management of complications by uniportal video-assisted thoracoscopic surgery. J Thorac Dis, 2014, 6(Suppl 6): S669-S673.
17.	Son BS, Park JM, Seok JP, et al. Modified incision and closure techniques for single-incision thoracoscopic lobectomy. Ann Thorac Surg, 2015, 99(1): 349-351.
18.	Gonzalez-Rivas D. Recent advances in uniportal video-assisted thoracoscopic surgery. Chin J Cancer Res, 2015, 27(1): 90-93.
19.	Jimenez MF. Uniportal versus standard video-assisted thoracoscopic surgery for lung lobectomy: changing the standards requires scientific evidence. Eur J Cardiothorac Surg, 2014, 47(5): 916.

1. 牟国卫, 刘伦旭. 单孔电视胸腔镜手术临床应用的现状与进展. 中国胸心血管外科临床杂志, 2012, 19(2): 181-184.
2. Jutley RS, Khalil MW, Rocco G. Uniportal vs standard three—port VATS technique for spontaneous pneumothorax: comparison of postoperative pain and residual paraesthesia. Eur J Cardiothorac Surg, 2005, 28 (1): 43-46.
3. Gaetano R, Nicola M, Carmine LM, et al. Ten-year experience on 644 patients undergoing single-port (Uniportal) video-assisted thoracoscopic surgery. Ann Thorac Surg, 2013, 96(2): 434-438.
4. Gonzalez-Rivas D, de la Torre M, Fernandez R, et al. Single-port video-assisted thoracoscopic left upper lobectomy. Interact Cardiovasc Thorac Surg, 2011, 13(5): 539-554.
5. Gonzalez-Rivas D, Paradela M, Garcia J, et al. Single-port video-assisted thoracoscopic lobectomy. Interact Cardiovasc Thorac Surg, 2011, 12(3): 514-515.
6. Gonzalez-Rivas D, Paradela M, Fernandez R, et al. Uniportal video-assisted thoracoscopic lobectomy: two years of experience. Ann Thorac Surg, 2013, 95(2): 426-432.
7. Gonzalez-Rivas D, de la Torre M, Femandez R, et al. Single-incision video-assisted thoracoscopic right pneumonectomy. Surg Endosc, 2012, 26(7): 2078-2079.
8. Licht PB, Jorgensen OD, Ladegaard L, et al. A national study of nodal upstaging after thoracoscopic versus open lobectomy for clinical stage I lung cancer. Ann Thorac Sur, 2013, 25(23): 1l02-1107.
9. Gonzalez-Rivas D, Fieira E, Delgado M, et al. Is uniportal thoracoscopic surgery a feasible approach for advanced stages of non-small cell lung cancer? J Thorac Dis, 2014, 6(6): 641-648.
10. Non-small cell lung cancer version 4，2014，NCCN Clinical Practice Guidelines in Oncology. Available from: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp#nscl, 2015-10-12.
11. Lin Z, Xu S, Wang Q. Uniportal video-assisted thoracoscopic surgery right upper lobectomy with systematic lymphadenectomy in a semiprone position. J Thorac Dis, 2014, 6(12): 1840-1842.
12. Chung JH, Choi YS, Cho JH, et al. Uniportal video-assisted thoracoscopic lobectomy: an alternative to conventional thoracoscopic lobectomy in lung cancer surgery? Interact Cardiovasc Thorac Surg, 2015, 20(6): 813-819.
13. Puri V, Meyers BF. Video-assisted thoracoscopic surgery lobectomy for lung cancer. Surg Oncol Clin N Am, 2013, 22 (1): 27-38.
14. Fieira Costa E, Delgado Roel M, Paradela M, et al. Technique of uniportal VATS major pulmonary resections. J Thorac Dis, 2014, 6(Suppl 6): S660-S664.
15. McElnay PJ, Molyneux M, Krishnadas R, et al. Pain and recovery are comparable after either uniportal or multiport video-assisted thoracoscopic lobectomy: an observation study. Eur J Cardiothorac Surg, 2015, 47(5): 912-915.
16. Fernández Prado R, Fieira Costa E, Delgado Roel M, et al. Management of complications by uniportal video-assisted thoracoscopic surgery. J Thorac Dis, 2014, 6(Suppl 6): S669-S673.
17. Son BS, Park JM, Seok JP, et al. Modified incision and closure techniques for single-incision thoracoscopic lobectomy. Ann Thorac Surg, 2015, 99(1): 349-351.
18. Gonzalez-Rivas D. Recent advances in uniportal video-assisted thoracoscopic surgery. Chin J Cancer Res, 2015, 27(1): 90-93.
19. Jimenez MF. Uniportal versus standard video-assisted thoracoscopic surgery for lung lobectomy: changing the standards requires scientific evidence. Eur J Cardiothorac Surg, 2014, 47(5): 916.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

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Clinical Significance of Lymph Node inside Lung Dissection of Non-small Cell Lung Cancer in Stage T₁