[Lymph node dissection during a video-assisted lobectomy is inferior to that in a standard lobectomy].

Abstract

The indications for a video-assisted lobectomy are currently ill-defined. Clinicians recommend based on the extent of lymph node involvement. Fifty-nine patients with clinical stage I non-small cell lung cancer underwent lobectomies with systemic lymph node dissections through a standard thoracotomy (Group C), and 26 patients underwent lobectomies with lymph node dissections using the video-assisted procedure (Group V). The number of dissected lymph nodes at all node levels were compared between the two groups. There was no significant difference between groups in the total number of dissected lymph nodes in patients with right lung cancer. The number of dissected hilar and interlobar lymph nodes, however, was less in Group V than that in Group C (hilar: 1.2 +/- 0.4 vs. 2.8 +/- 0.6, interlobar: 1.1 +/- 0.4 vs. 2.1 +/- 0.4). The total number of dissected lymph nodes in patients with left lung cancer was significantly less in Group V than that in Group C (18.5 +/- 0.3 vs. 28.7 +/- 2.4). In addition, the number of dissected lymph nodes in pratracheal, pretracheal, tracheobronchial, subcarinal, hilar, and interlobar lymph nodes were significantly less in the group V than those in Group C. Although there was no significant difference in the actual survival rates between the groups in this preliminary study, a sufficiently small number of dissected lymph nodes in the video-assisted lobectomy may have resulted in inaccurate staging and poor prognosis in these patients.