Perioperative outcomes of video-assisted thoracoscopic surgery versus thoracotomy after neoadjuvant therapy for non-small cell lung cancer: A retrospective cohort study
- VernacularTitle:非小细胞肺癌新辅助治疗后开胸与胸腔镜围手术期疗效的回顾性队列研究
- Author:
Yang QING
1
;
Meixin TENG
1
;
Wangchao YAO
2
;
Jing ZHANG
2
;
Peng ZHANG
1
Author Information
1. 1. Medical College of Shihezi University, Shihezi, 832002, Xinjiang, P. R. China 2. Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Shanghai, 200092, P. R. China
2. 2. Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Shanghai, 200092, P. R. China 3. Central Laboratory, Shanghai Pulmonary Hospital, Shanghai, 200092, P. R. China
- Publication Type:Journal Article
- Keywords:
Neoadjuvant therapy;
non-small cell lung cancer;
video-assisted thoracoscopic surgery;
thoracotomy
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2025;32(04):488-499
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the perioperative differences between video-assisted thoracoscopic surgery (VATS) and thoracotomy after neoadjuvant therapy in patients with non-small cell lung cancer (NSCLC). Methods Clinical data of NSCLC patients who underwent VATS or thoracotomy after neoadjuvant therapy at Shanghai Pulmonary Hospital from June 2020 to May 2022 were retrospectively collected. Perioperative outcomes were compared between the two groups. Results A total of 260 patients were enrolled, 184 (70.8%) patients underwent VATS and 76 (29.2%) patients underwent thoracotomy. After propensity matching, there were 113 (62.4%) patients in the VATS group and 68 (37.6%) patients in the thoracotomy group. VATS had similar lymph node dissection ability and postoperative complication rate with thoracotomy (P>0.05), with the advantage of having shorter operative time (146.00 min vs. 165.00 min, P=0.006), less intraoperative blood loss (50.00 mL vs. 100.00 mL, P<0.001), lower intraoperative blood transfusion rate (0.0% vs. 7.4%, P=0.003), less 3-day postoperative drainage (250.00 mL vs. 350.00 mL, P=0.011; 180.00 mL vs. 250.00 mL, P=0.002; 150.00 mL vs. 235.00 mL, P<0.001), and shorter postoperative drainage time (9.34 d vs. 13.84 d, P<0.001) and postoperative hospitalization time (6.19 d vs. 7.94 d, P=0.006). Conclusion VATS after neoadjuvant therapy for NSCLC is safer than thoracotomy and results in better postoperative recovery.
