• Yue Zhao, Guodong Li, Yang Zhang, Hong Hu, Jie Zhang, Yihua Sun, and Haiquan Chen.
• Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
• J. Thorac. Cardiovasc. Surg. 2017 Oct 1; 154 (4): 1420-1429.e1.

ObjectiveTo compare short-term complications and long-term survival outcomes between muscle-sparing thoracotomy (MST) and video-assisted thoracic surgery (VATS) groups using a propensity-score matching process.MethodsOne thousand eighty-three patients with cT1 N0 M0 lung cancer from January 2009 to December 2014 who underwent lobectomy and a systematic lymph node dissection were retrospectively included, and statistical analyses including a propensity-score matching process were used to compare short-term and long-term outcomes.ResultsBefore propensity-score matching, for short-term surgical outcomes, the VATS group had fewer chest tube dwelling days (P < .001), less chest tube output (P < .001), shorter hospital stay, and fewer postoperative complications (P = .015). For long-term survival outcomes, the VATS group had a longer recurrence-free survival (P < .001) and overall survival (P < .001). After propensity-score matching, for short-term surgical outcomes, the VATS group had fewer chest tube dwelling days (P < .001), less chest tube output (P < .001), shorter hospital stay (P = .002), and fewer postoperative complications (P = .008). There was no difference in recurrence-free survival and overall survival between the 2 groups (P = .158 and P = .639, respectively).ConclusionsVATS is less invasive and is associated with shorter length of hospital stay and fewer postoperative complications. The 2 surgical approaches have equivalent long-term survival outcomes.Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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