Outcomes of fast trackvideo-assisted thoracoscopic surgery fornon-smallcell lungcancer

Abstract

Objective To investigate the outcomes of fast track video-assisted thoracoscopic surgery for non-smallcell lung cancer, and summarize the treatment experience. Methods The clinical data of 240 patients with non-smallcell lung cancer treated in the Affiliated Hospital of Hainan Medical College between October 2011and October 2013 were retrospectively analyzed. Among these 240 patients, 170 were treated by video-assisted thoracoscopic surgery (thoracoscopic surgery group), and the other 70 were managed with conventional thoracotomy(conventional thoracotomy group). The operation time, volume of blood loss during operation, volume of postoperative chest drainage, chest tube intubation time, postoperative hospital stay and incidence of complications were compared between two groups, and the related indicators of immune stress before anesthesia(T0), 1h after skin incision(T1), at the end of operation(T2), 24 h after operation(T3) and 48 h after operation(T4) were observed. Results There was no case ofperioperative death in two groups. The operation time, volume of blood loss during operation, volume of postoperative chest drainage, chest tube intubation time and postoperative hospital stay in thoracoscopic surgery group were significantly better than those in conventional thoracotomy group(t=-11.0, P=0.00; t=-3.2, P=0.00; t=-12.7, P=0.00; t=-9.4, P=0.00; t=-6.0, P=0.00). However, there was no significant difference in the incidence of postoperative complications between two groups (χ2=1.48, P=0.22). The related indicators of immune stress 24 h after operation (T3) and 48 h after operation (T4) in thoracoscopic surgery group were significantly higher than those in conventional thoracotomy group (P<0.01). The concentration of norepinephrine (NE) in the peripheral blood 24 h after operation (T3) and 48 h after operation (T4) in thoracoscopic surgery group was lower than that in conventional thoracotomy group (t=-11.81, P=0.00; t=-20.06, P=0.00). Conclusions Thoracoscopic surgery has the advantages of shorter operation time and hospitalization time, smaller volumes of blood loss during operation and postoperative drainage, less postoperative stress and immune response, and is worthy of application. Key words: Thoracoscopic surgery; Fast track; Non-small cell lung cancer