Effect of video-assisted thoracoscopic lobectomy on cardiac and respiratory functions in elderly patients with non-small cell lung cancer

  Objective  To investigate the clinical efficacy of video-assisted thoracic surgery (VATS) in the treatment of elderly non-small cell lung cancer (NSCLC).

  Methods  A total of 92 elderly patients with NSCLC admitted to our hospital were randomly divided into control group and observation group, with 46 cases in each group. The control group was treated with classical treatment of thoracotomy plus mediastinal lymph node dissection, while the observation group was treated with VATS. The operation-related indexes, cardiac function heart rate, (HR), pulse oxygen saturation (SpO₂)and respiratory function indexesforced vital capacity (FVC), forced expiratory volume in the first second(FEV₁), maximal voluntary ventilation(MVV)were compared between the two groups. The incidence of complications, hospital stay and expenses were compared.

  Results  The operation was successfully completed in both groups, and no patients conversed to thoracotomy in the observation group. There were no significant differences in operation time and number of lymph node dissection between the two groups (P>0.05). Incision length, intraoperative bleeding volume and indwelling drainage time of the observation group were shorter than that of the control group(P < 0.01); but no differences were observed in HR, SpO₂, FVC, FEV₁, MVV of the two groups(P>0.05). The above indexes(except for SpO₂) at 1 week after treatment of the two groups showed significant differences compared with treatment before(P < 0.05), and showed significant between-group differences(P < 0.05). The complication rate of the observation group was lower than that of the control group (6.52% vs. 21.74%, P < 0.05), and the hospitalization time and medical expenses were (11.93±2.57) d, (3.06±0.58) ten thousand RMB, which were significantly lower than (13.62±3.14) d, (3.43±0.75) ten thousand RMB(P < 0.05).

  Conclusion  Video-assisted thoracoscopic lobectomy (VATS) for elderly patients with NSCLC can not only achieve the same effect as thoracotomy for resection of tumors, but also have the advantages of less impact on cardiac function and pulmonary respiratory function, rapid recovery and less complication, and lower medical costs.