摘要
目的比较胸腔镜肺叶切除术与开胸肺叶切除术对早期非小细胞肺癌患者生存率的影响。方法回顾性分析2008年3月-2014年1月于该院胸外科行肺叶切除术的临床分期为I期的非小细胞肺癌患者的临床资料及随访资料,根据手术方式将患者分为胸腔镜组(行胸腔镜手术)及开胸组(行常规开胸手术)。结果共有155例临床分期为I期的非小细胞肺癌患者行肺叶切除术,其中82例行胸腔镜手术,73例行开胸手术。两组患者的一般资料比较差异无显著性(P>0.05)。胸腔镜组患者虽然手术时间长于开胸组(P<0.05),但创伤较小,具体表现为术中失血量较少(P<0.05)、术后镇痛天数较短(P<0.05)、术后引流天数较短(P<0.05)及住院天数较短(P<0.05)。两组患者术后30 d内总体并发症发生率类似(P>0.05),但胸腔镜组患者严重并发症发生率低于开胸组患者(P<0.05)。两组患者淋巴结清扫结果类似(P>0.05)。两组患者的总体生存率及无瘤生存率均类似,且该研究的生存率数据与其他学者报道的数据类似。结论胸腔镜肺叶切除术用于早期非小细胞肺癌(NSCLC)时可取得与开胸手术类似的生存率,可选用为早期NSCLC的治疗手段。
【Objective】The aim of this study was to compare the outcomes of lobectomy in video-assisted thoracoscopic surgery（VATS） and thoracotomy for clinical stage I non-small-cell lung cancer（NSCLC）.【Methods】The short-term and long-term data of 155 consecutive patients who underwent lobectomy for clinical stage I NSCLC via VATS or thoracotomy between March 2008 and January 2014 were retrospectively reviewed. The primary endpoints were mediastinal lymph node, overall survival and disease-free survival. 【Results】The lobectomy was performed for 155 clinical stage I NSCLC patients,of which,82 received VATS and 73 received thoracotomy. Patients＇ demographic data were similar in both groups. There were less blood loss, less post-operative analgesia needed and earlier hospital discharge by VATS than by thoracotomy. Overall morbidity was similar in the two groups. However,the rate of major complications was higher after thoracotomy than VATS. There were no 30-day mortality in thoracotomy and VATS. There were no significant differences when comparing the results of lymphadenectomy. The overall survival and disease-free survival were comparable between the two groups. Our oncological outcomes were similar to other large sample size studies.【Conclusion】In summary, it is reasonable to conclude from out study that VATS lobectomy done by dedicated thoracic surgeons is safe and can achieve similar long-term survival to open approach.
出处
《中国内镜杂志》
北大核心
2015年第3期225-229,共5页
China Journal of Endoscopy
关键词
胸腔镜
肺癌
肺叶切除术
预后
video-assisted thoracoscopic surgery
lung cancer
lobectomy
outcomes
