Experience and development of the video-assisted thoracic surgery lobectomy technique: comparative study with conventional surgery in stage I non-small cell lung cancer.

BACKGROUND Surgical treatment of stage I non-small cell lung cancer (NSCLC) can be performed either by thoracotomy or by employing video-assisted thoracic surgery (VATS). The aim of this study was to compare long and short-term results of conventional surgery (CS) vs. VATS lobectomy in the treatment of stage I NSCLC. MATERIALS AND METHODS We performed a retrospective, analytical study of patients undergoing surgery for stage I NSCLC during the period January 1993 to December 2005. The variables analyzed were overall survival, recurrence, distant metastasis, morbidity, mortality and hospital stay. During this period, 256 anatomic lung resections were performed: 141 by CS and 115 by VATS. RESULTS There were statistically significant differences in: (i)mean hospital stay in patients with no complications (VATS group: 4.3 days vs. CS group: 8.7 days, P=.0001); (ii)mean hospital stay in patients with complications (VATS: 7.2 days vs. CS: 13.7 days, P=.0001), and (iii)morbidity (VATS: 15.6% vs. CS: 36.52%, P=.0001). No statistically significant differences were found in: (i)mortality (VATS: 2.17% vs. CS: 1.7%, P=.88); (ii)5-year overall survival (VATS: 68.1% vs. CS: 63.8%), and (iii) local recurrence and distant metastasis (P=.82). CONCLUSIONS VATS lobectomy is a safe and effective approach, with a shorter hospital stay and lower morbidity than CS; no statistically significant differences were observed in survival in patients undergoing surgery for stage I NSCLC.