摘要
目的 总结采用北京大学人民医院方法进行全胸腔镜肺叶切除的3家单位连续600例全胸腔镜肺叶切除临床资料和中期随访结果.方法 回顾性分析2006年9月至2010年8月期间在北京大学人民医院、江苏省肿瘤医院和北京市海淀医院胸外科接受全胸腔镜肺叶切除病例600例,其中男315例,女285例 平均年龄（59.1±12.6）岁.对其手术相关参数及3年随访结果等进行统计分析.结果 全组600例中良性疾病119例,占68.9%,其中感染性疾病82例 恶性肿瘤481例,主要为非小细胞肺癌437例（以腺癌为主,317例,占全部恶性疾病的65.9%）.全组546例完成全胸腔镜手术,54例中转开胸,中转率9.0%.完成胸腔镜手术者手术时间30～340min,中位值180min 术中出血10～1500 ml,中位值200 ml.良性病变的手术时间、术后引流时间、术后住院天数及术后并发症发生率均显著低于恶性疾病,P值分别为0.001、0.01、0.004、0.020.3年随访结果显示,良性疾病无症状复发,全胸腔镜下完成手术的非小细胞肺癌3年总生存率85.4%,其中Ⅰ期病人3年总生存率91. 2%.结论 全胸腔镜肺叶切除手术安全、有效.
Objective To report a multi-center series of 600 consecutive cases of completely video-assisted thoracoscopic lobectomy with 3-year follow-up results. Methods Data from 600 consecutive patients who underwent attempts for thoracoscopic lobectomy between September 2006 and August 2010 in Peking University People＇s Hospital, Jiangsu Cancer Hospital and Beijing Haidian Hospital were collected. Of these, 315 males （52.5%） and 285 females （47.5%）, the average age was （ 59.1 ± 12.6 ） years（ 15 - 86 years）. Perioperative variables were assessed using standard descriptive statistics and 3-year survival was estimated by Kaplan-Meier analyses. Results One hundred and nineteen cases were diagnosed as benign disease and 481 cases were malignancy. 68.9% （82/119） of the benign cases were chronic infectious disease and the majority of the malignancy was non-small cell lung cancer, especially adenocarcinomas which comprised 65.9% （317/481） of all malignancies.Fifty-four cases required conversion to thoracotomy with a conversion rate of 9%. Of the VATS accomplished group, the median operation time was 180 min（30 -40 min）, median blood loss 200 ml（ 10 - 1500 ml） . Benign surgery took significantly less time, had shorter drainage time and hospitalization time, and lower morbidity than that for malignancies （ P = 0.001, P 〈0.01, P = 0.004, P = 0.020, respectively）. Non-small cell lung cancer patients had a 3 -year survival of 85.4%, and pathologic stage Ⅰ patients 91.2%. Conclusion This largest case series and the first report 3-year survival in China confirms that completely thoracoscopic lobectomy surgery we performed have reached short- and middle-term standards compared with that of the western country.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2010年第5期307-309,293,共4页
Chinese Journal of Thoracic and Cardiovascular Surgery
