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Abstract：
OBJECTIVE: Lu\'s approach for video-assisted thoracoscopic surgery (LVATS), which derives from UVATS, is a novel surgical approach for VATS and carries out micro-innovation for lung cancer resection. The objective of this study is to elucidate the safety, feasibility, and efficacy of this novel surgical approach.
METHODS: The clinical data of patients with non-small cell lung cancer (NSCLC) who underwent a curative thoracoscopic lobectomy between Mar. 2021 and Mar. 2022, were retrospectively collected, and analyzed. According to whether applied Lu\'s approach during the VATS operation, patients were divided into the LVATS group and the UVATS group. The propensity score (PS) matching method was used to reduce selection bias by creating two groups. After generating the PSs, 1:1 ratio and nearest-neighbor score matching was completed. Perioperative variables, including the operation time, intraoperative blood loss, lymph node stations dissected, total drainage volume, drainage duration, postoperative hospital stay, pain score (VAS, Visual Analogue Scale) on the postoperative first day (POD1) and third day (POD3), and incidence of postoperative complications, were compared between the two groups. The data were analyzed statistically with P<0.05 defined as statistically significant.
RESULTS: A total of 182 patients were identified, among whom 86 patients underwent LVATS and 96 UVATS. Propensity matching produced 62 pairs in this retrospective study. There were no deaths during perioperative period. Patients in the LVATS group experienced a shorter operation time (88 (75, 106) VS 122 (97, 144)min, P <0.001), less intraoperative blood loss(20 (20, 30) VS 25 (20, 50)ml, P = 0.021), shorten incision length (2.50 (2.50, 2.50) VS 3.00 (3.00, 3.50)cm, P <0.001), and more drainage volume (460 (310, 660) VS 345 (225, 600)ml, P = 0.041) than patients in the UVATS group. There was not significant difference in the lymph node stations dissected(5 (4, 5) VS 5 (4, 5), P = 0.436), drainage duration (3 (3, 4) VS 3 (3, 4)days, P = 0.743), length of postoperative hospital stay (4 (4, 5) VS 4 (4, 6)days, P = 0.608), VAS on the POD1(4 (4, 4) VS 4 (4, 4), P = 0.058)and POD3 (3 (3, 4) VS 4 (3, 4), P = 0.219), and incidence of postoperative complications (P = 0.521) between the two groups.
CONCLUSIONS: Lu\'s approach is a safe and feasible approach for video-assisted thoracoscopic surgery for the lobectomy of NSCLC. This approach can shorten surgical time, reduce incision length and intraoperative blood loss.
METHODS: The clinical data of patients with non-small cell lung cancer (NSCLC) who underwent a curative thoracoscopic lobectomy between Mar. 2021 and Mar. 2022, were retrospectively collected, and analyzed. According to whether applied Lu\'s approach during the VATS operation, patients were divided into the LVATS group and the UVATS group. The propensity score (PS) matching method was used to reduce selection bias by creating two groups. After generating the PSs, 1:1 ratio and nearest-neighbor score matching was completed. Perioperative variables, including the operation time, intraoperative blood loss, lymph node stations dissected, total drainage volume, drainage duration, postoperative hospital stay, pain score (VAS, Visual Analogue Scale) on the postoperative first day (POD1) and third day (POD3), and incidence of postoperative complications, were compared between the two groups. The data were analyzed statistically with P<0.05 defined as statistically significant.
RESULTS: A total of 182 patients were identified, among whom 86 patients underwent LVATS and 96 UVATS. Propensity matching produced 62 pairs in this retrospective study. There were no deaths during perioperative period. Patients in the LVATS group experienced a shorter operation time (88 (75, 106) VS 122 (97, 144)min, P <0.001), less intraoperative blood loss(20 (20, 30) VS 25 (20, 50)ml, P = 0.021), shorten incision length (2.50 (2.50, 2.50) VS 3.00 (3.00, 3.50)cm, P <0.001), and more drainage volume (460 (310, 660) VS 345 (225, 600)ml, P = 0.041) than patients in the UVATS group. There was not significant difference in the lymph node stations dissected(5 (4, 5) VS 5 (4, 5), P = 0.436), drainage duration (3 (3, 4) VS 3 (3, 4)days, P = 0.743), length of postoperative hospital stay (4 (4, 5) VS 4 (4, 6)days, P = 0.608), VAS on the POD1(4 (4, 4) VS 4 (4, 4), P = 0.058)and POD3 (3 (3, 4) VS 4 (3, 4), P = 0.219), and incidence of postoperative complications (P = 0.521) between the two groups.
CONCLUSIONS: Lu\'s approach is a safe and feasible approach for video-assisted thoracoscopic surgery for the lobectomy of NSCLC. This approach can shorten surgical time, reduce incision length and intraoperative blood loss.
摘要：
目的：Lu的方法用于电视胸腔镜手术（LVATS），源自UVATS，是一种新颖的VATS手术方法，并对肺癌切除术进行了微创新。这项研究的目的是阐明安全性，可行性,和这种新型手术方法的疗效。
方法：在3月之间接受了根治性胸腔镜肺叶切除术的非小细胞肺癌（NSCLC）患者的临床资料。2021年3月2022年，回顾性收集，并分析。根据在VATS操作过程中是否应用了Lu\'s方法，患者分为LVATS组和UVATS组。使用倾向评分（PS）匹配方法通过创建两组来减少选择偏差。生成PS后，完成1:1比率和最近邻分数匹配。围手术期变量,包括手术时间，术中失血,淋巴结站解剖，总排水量,排水持续时间,术后住院时间,疼痛评分(VAS，视觉模拟评分）在术后第一天（POD1）和第三天（POD3），术后并发症的发生率，对两组进行比较。对数据进行统计学分析,P<0.05定义为有统计学意义。
结果：共确认182例患者，其中86例患者接受LVATS和96例UVATS。在这项回顾性研究中，倾向匹配产生了62对。围手术期无死亡病例。LVATS组患者的手术时间较短（88（75，106）VS122（97，144）min，P<0.001)，术中出血量少（20（20，30）VS25（20，50）ml，P=0.021),缩短切口长度(2.50(2.50,2.50)VS3.00(3.00,3.50)cm,P<0.001)，和更多的排水量（460（310，660）VS345（225，600）毫升，P=0.041)高于UVATS组患者。解剖的淋巴结位置没有显着差异（5（4，5）VS5（4，5），P=0.436),排水持续时间(3(3，4)VS3(3，4)天，P=0.743),术后住院时间（4（4，5）VS4（4，6）天，P=0.608),POD1上的VAS(4(4,4)VS4(4,4),P=0.058)和POD3(3(3，4)VS4(3，4)，P=0.219),术后并发症发生率(P=0.521)。
结论：Lu\的方法是一种安全可行的方法，用于电视胸腔镜下NSCLC的肺叶切除术。这种方法可以缩短手术时间，减少切口长度和术中失血量。
方法：在3月之间接受了根治性胸腔镜肺叶切除术的非小细胞肺癌（NSCLC）患者的临床资料。2021年3月2022年，回顾性收集，并分析。根据在VATS操作过程中是否应用了Lu\'s方法，患者分为LVATS组和UVATS组。使用倾向评分（PS）匹配方法通过创建两组来减少选择偏差。生成PS后，完成1:1比率和最近邻分数匹配。围手术期变量,包括手术时间，术中失血,淋巴结站解剖，总排水量,排水持续时间,术后住院时间,疼痛评分(VAS，视觉模拟评分）在术后第一天（POD1）和第三天（POD3），术后并发症的发生率，对两组进行比较。对数据进行统计学分析,P<0.05定义为有统计学意义。
结果：共确认182例患者，其中86例患者接受LVATS和96例UVATS。在这项回顾性研究中，倾向匹配产生了62对。围手术期无死亡病例。LVATS组患者的手术时间较短（88（75，106）VS122（97，144）min，P<0.001)，术中出血量少（20（20，30）VS25（20，50）ml，P=0.021),缩短切口长度(2.50(2.50,2.50)VS3.00(3.00,3.50)cm,P<0.001)，和更多的排水量（460（310，660）VS345（225，600）毫升，P=0.041)高于UVATS组患者。解剖的淋巴结位置没有显着差异（5（4，5）VS5（4，5），P=0.436),排水持续时间(3(3，4)VS3(3，4)天，P=0.743),术后住院时间（4（4，5）VS4（4，6）天，P=0.608),POD1上的VAS(4(4,4)VS4(4,4),P=0.058)和POD3(3(3，4)VS4(3，4)，P=0.219),术后并发症发生率(P=0.521)。
结论：Lu\的方法是一种安全可行的方法，用于电视胸腔镜下NSCLC的肺叶切除术。这种方法可以缩短手术时间，减少切口长度和术中失血量。
