目的 探讨全胸腔镜下肺叶切除淋巴结清扫手术的安全性及应用价值。方法 采用前瞻性随机对照研究，比较胸腔镜和传统开胸肺癌根治术二组的手术时间、术中出血量、术后住院时间、术中淋巴结清扫枚数及住院费用等。结果 胸腔镜组26例手术顺利，1例因淋巴结融合伤及左上肺动脉中转开胸。与开胸手术比较，胸腔镜组出血少、术后放置胸管时间短、术后住院时间短、术后疼痛减轻；两组手术时间、淋巴结清扫数量无明显差异。胸腔镜组手术费用高于开胸组，而药费则低于后者，住院总费用两者差别无统计学意义。结论 胸腔镜下肺叶切除淋巴结清扫是安全可行的，具有创伤小、并发症少、疗效可靠、不增加住院费等优点，有良好临床应用前景。

Objective To explore the safety and applicability of video-assited thorascopic lobectomy and lymphadenectomy for lung cancer. Methods A prospective randomized controlled study was conducted. Fifty-four people who had been preoperatively confirmed to be patients of lung cancer from 2008 to 2012 were divided into VATS group and standard thoracotomy group. The operation time, blood loss, length of hospital stay, number of dissected lymph nodes and cost of treatment were compared between the two groups. Results One patient in the VATS group was subjected to open surgery. There was significant difference between the two groups in blood-loss, postoperative drainage time and the length of hospital stay, but not in the operation time or the number of dissected lymph nodes. The average cost of surgery in VATS group was much higher than that of thoracotomy group （P<0.01） while the average cost of drugs in VATS group was much lower （P<0.01）. Conclusion Thorascopic lobectomy and lymphadenectomy by VATS is safe and feasible with the advantage of less invasion, less surgical trauma and pain, a lower rate of complication, lower costs and better curative effect.