Abstract: Objective Two-incision video-assisted thoracic surger relieved post operative pain when compared with open thoractomy, while it is rarely reported worldwide，most thoracic surgeons think it is hard to finish the complicated operation and it is not safe.We compared the safety between open and two-incision VATS. Methods Bwteen Febrary 2009 to December 2011, a total of 334 cases with clinical early-staged lung cancer of open thoracotomy were performed , 66 cases were completely performed with 2-incision VATS, 17 cases were transferred to open thoracotomy defined as two-incision VATS assisted thoracotomy. We compared and analyzed open thoracotomy with two-incision VATS in operating time, and pre,post and total period of hospitalization, postoperative chest tube removal time, postoperative complications. Results Operating time in the left lower lobe of both traditional open thoracotomy and two-incision VATS was 162.5 ± 6.5 and 185.8 ± 12.8 minutes respectively(p=0.1228),there was no statistical significance for the remaining parts of the lobectomy, the operating time of open thoracotomy was shorter than two-incision VATS. The overall complication and perioperative mortality rate of open thoracotomy and two-incision VATS were 10.2% and 15.0%(P = 0.238), and 2.0% and 0.0% (p=1.000)respectively, there was no statistical significance. ConclusionThe lobectomy and lymph node dissections for 2-incision VATS in treating clinical stage I lung cancer is feasible and safe.

Key words: Lung cancer , Lobectomy , two-incision Thoracoscopy/VATS