Lobectomy is the surgical treatment of choice for resectable lung cancer. Because of lack of consensus on the most appropriate surgical methods, both open lobectomy (OL) and thoracoscopic lobectomy (TL) are performed. A retrospective analysis is performed for the outcomes and cost of TL versus OL.

289 patients from outpatient and emergency department from December 2013 to November 2016 were retrospectively analyzed. The information of these patients includes age, gender, operation time, discharge prognosis, notch healing grade, length of stay and total cost. Nonparametric Mann-Whit-ney U test is performed for numerical variables and ordinal variables, Chi-square test with Yates correction or Fisher exact test is used for nominal variables.

The length of stay after operation of TL group was less than OL group for 1 day and the difference is significant (P=0.003). The time of antibiotic treatment of TL group were less than OL group for 3 days, and the difference between the two groups was statistically significant (P=0.03). The median operation time and amount of bleeding of TL were lower than those of OL and the difference between the two groups was statistically significant (P=0.031, P<0.0001). There is no significant difference for the cost of antibiotics in outpatient department within one month after discharge and the total cost of treatment (including the cost of antibiotics in outpatient department within one month after discharge). The difference of discharge prognosis between TL and OL is not significant (P=0.83). The notch grade of OL is superior to TL and the difference of the notch grade between TL and OL is significant (P=0.001). The total volume of chest drainage of TL is less than that of OL and the difference is significant (P=0.006).

TL is a safe and effective method of lobectomy. There is shorter length of stay, operative time, days of antibiotic treatment, less amount of bleeding and less total volume of chest drainage after operation. There is no statistical difference in the total hospital cost and the cost of antibiotics in outpatient department within one month after discharge between TL and OL. TL can be a safe alternative treatment to OL for patients with resectable lung cancer in the future.