Abstract: Objective The aim of this study is to evaluate whether video-assisted thoracoscopic surgical(VATS)lobectomy is as effective as open thoracotomy lobectomy for complete dissection of the mediastinal lymph node(MLN).Methods Patients with clinical stage N₀ lung cancer who underwent lobectomy between January 2008 and June 2013 were retrospectively evaluated based on the LN station resected and lobectomy procedure used,and a resection ratio was calculated.Nodal stage and the proportion of patients,from whom at least three MLNs and station 7 were dissected and compared by lobectomy type.Results Of the 201 patients enrolled in the study,84 and 117 underwent VATS and open thoracotomy lobectomies,respectively.The mean number of LNs dissected at station 3a was similar in the two groups(1.34 ± 2.58 vs. 1.52 ± 1.78;P＞0.05),but the resection ratio differed(39% vs. 63%;P＜0.05).However,there were no differences at stations 7 and 9R in terms of the number of LNs dissected or resection ratio for the right-sided approaches(P＞0.05).There were no differences in the number of LNs dissected or resection ratio between the two groups for stations 4L,5L,6L,7L,and 9L for the left-sided approaches.Only station 8L showed significant differences between the VATS and open thoracotomy groups in the number of LNs dissected(0.12 ± 0.44 vs.0.46 ± 0.71;P＜0.05)and resection ratio(8% vs. 36%;P＜0.05).There were no differences in the number of LNs dissected or resection ratio between groups for station 7: 82.1% of patients in each group had at least three MLNs and station 7 removed(P＞0.05).The Kaplan-Meier 5-year survival was also similar between the two groups(log-rank test,P＞0.05).Conclusion VATS lobectomy is as effective as open thoracotomy lobectomy for the dissection of MLNs.Thus,VATS lobotomy resection will continue to be offered as the best choice for patients with clinical stage N₀.