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OBJECTIVE To evaluate the indication and short-term outcomes of video assisted thoracic surgery (VATS) for lung tumors. METHODS Data of 306 consecutive patients undergoing VATS pulmonary resection between January 2009 and August 2010 in Cancer Institute & Hospital, Chinese Academy of Medical Sciences were retrospectively reviewed. RESULTS There were 7 patients who underwent open thoracotomy, accounting for 2.29% (7/306). The overall morbidity rate of complications and the mortality rate induced by VATS was 1.63% (5/306) and 0.33% (1/306), respectively. There were no significant differences in morbidity and mortality rate between the patients receiving the VATS and the patients receiving the OT. The overall hospitalization, postoperative length of stay (LOS) and chest tube duration in the VATS lobectomy group (n = 167) were shorter than those in the open thoracotomy (OT), but the operative time in the VATS group was longer than that in the OT group (n = 124). There were no signifi cant differences in the number of station of lymph nodal dissection (LND) and number of LND in pathological stage I between VATS group and OT group, but signifi cant differences were found in the number of station of LND and the number of LND in pathological stage II and stage IIIA between the 2 groups. Compared with those who underwent OT wedge resection (n = 72), the patients who underwent VATS wedge resection (n = 108) had shorter operative time, chest tube duration and hospital LOS, and there were no significant differences in morbidity of the complications and mortality between the 2 groups.CONCLUSION VATS lobectomy can be performed for patients with clinical stage I lung cancer (with tumor diameter smaller than 5 cm, without hilar and mediastinal lymph node enlargement). VATS lobectomy is superior to OT lobectomy in short-term outcomes, although further studies exploring long-term outcomes through longer follow-up is needed to determine the oncologic equivalency between the VATS and the open lobectomy. VATS is also superior to OT in pulmonary wedge resection.