Clinical efficacy of video-assisted thoracoscopic lobectomy in the treatment of primary lung cancer in elderly patients

Abstract

Objective To evaluate the clinical efficacy of video-assisted thoracoscopic lobectomy in the treatment of primary lung cancer in elderly patients. Methods Clinical data of 50 elderly patients with primary non-small cell lung cancer undergoing lobectomy at our hospital from July 2016 to July 2017 were retrospectively analyzed.The patients were divided into video-assisted thoracoscopic surgery(VATS)group(n=30)and conventional thoracotomy group(n=20). General data of surgery including operating time, intraoperative bleeding volume, the total volume of intraoperative drainage, the group number of lymph node dissection and the number of dissected lymph nodes, and postoperative data including duration of chest tube drainage, the first 24 h post-operative pain numeric rating scale(NRS)score, postoperative hospitalization time and 30-day postoperative complication were analyzed and compared between the two groups. Results All operations were successfully completed in all patients of both groups, and no patient died during the perioperative period.The differences were statistically significant between VATS and traditional thoracotomy groups in operating time[(96.8±10.2)min vs.(126.3±16.1)min, t=6.211, P=0.036], in transoperative bleeding[(101.3±12.7)ml vs.(128.3±14.6)ml, t=4.310, P=0.027]and in total volume of intraoperative draining[(231.7±31.6)ml vs.(295.6±39.8)ml, t=5.610, P=0.018]. VATS showed superiority over traditional thoracotomy.In VATS groups vs.the traditional thoracotomy group, the duration of chest tube drainage was[(3.0±0.6)d vs.(3.9±0.8)d, t=5.317, P=0.022], postoperative pain NRS score was[(3.61±1.09)vs.(5.3±1.3)score, t=6.290, P=0.016]and postoperative hospitalization time was[(5.9±1.6)d vs.(8.9±1.9)d, t=3.069, P=0.031]. In addition, the incidences of postoperative complications were lower in the VATS group than in the traditional thoracotomy group(1/30 or 3.3% vs.5/20 or 25.0%, χ2=5.335, P=0.021). Conclusions Video-assisted thoracoscopic lobectomy is safe and effective in treating primary lung cancer in elderly patients and can promote postoperative recovery, which is more suitable for elderly patients with primary lung cancer. Key words: Carcinoma, non-small-cell lung; Thoracoscopy; Pneumonectomy