2024 Asia Conference on Lung Cancer (ACLC) - Poster & ePosters-PP01.63

PP01.63 - Jun Yi

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The study aimed to investigate the feasibility and safety of performing video-assisted thoracoscopic surgery (VATS) subcarinal lymph node dissection while preserving the vagus nerve pulmonary branch in patients with non-small cell lung cancer (NSCLC). A retrospective analysis was conducted on 170 patients who underwent VATS lobectomy and mediastinal lymph node dissection from March 2019 to July 2022. The patients were divided into two groups: Group A (78 patients) had the vagus nerve preserved at the pulmonary hilum, while Group B (92 patients) underwent standard dissection without nerve preservation.<br /><br />Key surgical and postoperative outcomes such as the number of lymph nodes dissected, operation time, intraoperative bleeding, chest tube duration, hospital stay, and postoperative complications were compared between the two groups. Notably, the only significant differences found were in rates of postoperative arrhythmias—favoring Group A—and significantly better postoperative cough outcomes in Group A, with higher LCQ-MC scores at 2 and 4 weeks after surgery.<br /><br />The study concluded that preserving the vagus nerve during VATS lymph node dissection in NSCLC is technically feasible and does not increase surgical complications. Additionally, it can improve postoperative outcomes related to coughing and lung infections, attributed to maintaining vagus nerve function using membrane anatomy principles and the mediastinal pleura hanging technique. Overall, the study supports the safety and benefits of preserving the vagus nerve in specific thoracic surgeries, highlighting its potential in minimizing certain postoperative complications.

Keywords

VATS

NSCLC

vagus nerve preservation

subcarinal lymph node dissection

postoperative outcomes

retrospective analysis

thoracic surgery

mediastinal pleura hanging technique

postoperative complications

LCQ-MC scores