Abstract

Abstract Background To compare the outcomes and costs of two methods of video‐assisted thoracoscopic surgery (VATS) major pulmonary resection in patients with clinically resectable non‐small cell lung cancer (NSCLC). Methods Between January 2000 and December 2007, 1,058 patients with proven stages I–IIIA NSCLC underwent complete VATS (c‐VATS) or assisted VATS (a‐VATS) major pulmonary resection together with a systematic nodal dissection. Results The study cohort consisted of 736 men and 322 women. Mean operative time was shorter for the a‐VATS cohort compared with the c‐VATS group ( P = 0.038). Overall survival (OS) at 5 years based on Kaplan–Meier analysis was 55.3% (95%CI, 50.6–60.0%) for those who underwent c‐VATS and 47.7% (95%CI, 41.2–54.2%) for those who underwent a‐VATS ( P = 0.404). Gender, final pathology, TNM stage, and pT status were significant predictive factors for OS according to multivariate analysis. The total cost of a‐VATS lobectomy was lower than that of c‐VATS lobectomy. Conclusions c‐VATS and a‐VATS yield similar results in patients with clinically resectable NSCLC. a‐VATS, however, may be less expensive and easier to adopt, making it a particularly attractive option for thoracic surgeons in developing countries. J. Surg. Oncol. 2011;104:162–168. © 2011 Wiley‐Liss, Inc.