[Analysis of invasive variation according to the different approaches of thoracoscopic resection for lung cancer]

There have been great variations among institutions in the approach of thoracoscopic surgery for lung cancer. However, we could not have found reports regarding the comparison study about operative invasion according to the thoracoscopic approach. We attempted to examine the differences of operative invasion in the various thoracoscopic approaches for lung cancer. We analyzed 158 cases of clinical stage I lung cancer by classifying thoracoscopic surgery into 3 different approaches. Specifically, group A (n=16) had less than 10 cm access with enlarged intercostal space by using rib-spreader, group B (n=84) had 4 to 8 cm access with soft material instrument and group C (n=50) had 2 to 3 cm access with soft material instrument. In each group, 2 or 3 thoracoports were added. Conversion to open thoracotomy were 8 cases. Operation time was significantly long in the conversion group, bleeding was significantly small in group C. Postoperative 48 hours drain discharge showed no differences in 3 groups, however, C-reactive protein (CRP) and creatine phosphokinase (CPK) with times showed significantly low level in group C, and both group A and conversion group were very close. Our results suggested the difference of the surgical invasiveness in thoracoscopic resection for lung cancer under various thoracoscopic approach.