摘要
目的探讨全胸腔镜肺叶切除术治疗Ⅰ/Ⅱ期非小细胞肺癌(NSCLC)患者的手术效果及安全性。方法回顾性分析2013年1月至2015年6月陕西省人民医院行肺癌切除138例Ⅰ/Ⅱ期NSCLC患者的临床资料,其中男88例、女50例,年龄44~76(57.4±8.8)岁。根据手术方法分为胸腔镜组(全胸腔镜肺叶切除术,63例)和开胸组(传统开胸手术治疗,75例),对比两组患者术中、术后临床指标、手术并发症、肺功能变化。结果胸腔镜组和开胸组的手术时间、术中淋巴结清扫组数、清扫数目差异均无统计学意义(P>0.05);胸腔镜组术中出血量、术后引流量、术后镇痛时间、疼痛程度评分(NRS评分)、住院时间均显著低于开胸组(P<0.05);手术前后第一秒用力呼气容积占预计值的百分比(FEVl%pred)、用力肺活量占预计值百分比(FVC%pred)两组之间差异均无统计学意义(P>0.05);两组术后FVC%pred、FEV1%pred比术前显著降低(P<0.05);胸腔镜组的手术并发症发生率显著低于开胸组(20.63%vs.32.00%,χ2=3.974,P=0.046)。结论全胸腔镜肺叶切除术治疗Ⅰ/Ⅱ期NSCLC患者手术效果可靠,且术后恢复快、并发症少。
Objective To evaluate the efficacy and safety of total thoracoscopic lobectomy for patients with stage Ⅰ/Ⅱ non-small cell lung cancer （NSCLC）. Methods The clinical data of 138 NSCLC patients from January 2013 to June 2015 in Shaanxi People＇s Hospital were retrospectively analyzed. There were 88 males and 50 females with an average age of 57.4±8.8 years, ranging from 44 to 76 years. According to the operation methods, they were divided into a video-assisted thoracoscopic surgery （VATS） group （thoracoscopic lobectomy in 63 cases） and a thoracotomy group （conventional open chest surgery in 75 cases）. The intra- and postoperative clinical data, surgical complications and pulmonary function were compared. Results There was no significant difference in the operation time, intraoperative lymph node dissection groups, intraoperative lymph node dissection number between two groups （P〉0.05）. The blood loss, postoperative drainage volume, duration of postoperative analgesia, Numeric Rating Scale for pain and hospital stay in the VATS group were significantly lower than those of the thoracotomy group （P〈0.05）. The pre- and postoperative FVC%pred and FEV1%pred in both groups were compared and there was no significant difference （P〉0.05）. However the postoperative FVC%pred and FEV1%pred in both groups significantly reduced compared with preoperative ones （P〈0.05）. Complication rate of thoracoscopic group was significantly less than that of the thoracotomy group （20.63%vs. 32.00%,χ^2=3.974,P=0.046）. Conclusion Thoracoscopic lobectomy for NSCLCⅠ/Ⅱpatients is reliable, and achieves rapid postoperative recovery as well as less complications.
出处
《中国胸心血管外科临床杂志》
CAS
CSCD
2017年第3期192-195,共4页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
关键词
胸腔镜手术
肺叶切除术
非小细胞肺癌
Video-assisted thoracoscopic surgery
lobectomy
non-small cell lung cancer
