摘要
目的:比较全胸腔镜与辅助小切口腔镜在肺癌切除的效果。方法:回顾性分析187例外科治疗的肺癌患者临床资料,分为全腔镜组(n=79)及小切口组(n=108),比较两组手术时间、并发症、炎症反应因子变化以及生存复发情况。结果:全腔镜组手术时间、出血量、住院时间、VAS评分均显著低于小切口组(P<0.05),两组患者淋巴结清扫数量、引流管留置时间、引流量均无统计学差异(P>0.05);全腔镜组并发症为13.9%,低于小切口组的26.9%(P<0.05);两组术后CRP、TNF-α、IL-6、IL-10均显著升高,小切口组CRP、TNF-α、IL-10升高更为显著(P<0.05),而IL-6升高水平两组无明显差异(P>0.05);平均随访时间(33.91±7.25)个月,两组1、2、3年复发及生存率无明显差异(P>0.05)。结论:全胸腔镜与小切口开胸肺癌切除均可做到彻底淋巴结清扫,有效控制复发率及死亡率。而腔镜更具微创伤、恢复快、并发症少及更低机体生物学应激反应的特点。
Objective： To compare the clinical outcome of VATS with minimally invasive thoracotomy for lung cancer surgery. Methods ： All 187 patients with lung cancer were divided into VATS group （ n = 79） and minimally in-vasive thoracotomy group （n = 108） . The operation time, complications, level of inflammatory factors and survival were analyzed. Results： The operation time,volume of blood loss,day of hospital stay,VAS scores in VATS group were sig-nificantly lower than that of minimally invasive thoracotomy group （P 〈0. 05） . But there was no significant difference between two groups in the number of lymph node, time and volume of drainage（ P 〉 0. 05 ） . The incidence of postoper-ative complication in the VATS group（13.9% ） was significantly lower than 26. 9% in minimally invasive thoracoto-my group （ P 〈 0. 05 ） . The level of serum CRP, TNF - α ,IL -6 ,IL -1 0 was significantly increased after operation, and CRP,TNF-a,IL - 10 were increased more significantly in the later group （P 〈0. 05） ,except IL -6 （P 〉 0. 05 ）. All patients were followed - up for （ 33. 91 ± 7. 25 ） months,in average. The incidence of recurrence and sur-vival rate of 1 year and 2,3 years was no significant difference between the two groups（P 〉0.05）. Conclusion： Both VATS and minimally invasive thoracotomy can achieve a complete lymphadenectomy and an effective control of mor-tality and tumor recurrence of patients with lung cancer. It seemed to be less injury, faster recovery and lower inci-dence of postoperative complications and light response of body for VATS.
出处
《现代肿瘤医学》
CAS
2016年第21期3398-3400,共3页
Journal of Modern Oncology
关键词
胸腔镜
肺叶切除
小切口开胸
肺癌
微创外科
临床应用
VATS, lobectomy,minimally invasive thoracotomy,lung cancer,microinvasive surgery,clinical applica-tion
