摘要
目的探讨电视胸腔镜手术(VATS)下微创肺段切除术在早期非小细胞肺癌(NSCLC)治疗中的可行性和有效性。方法根据手术方式的不同将86例NSCLC患者分为观察组(行VATS肺段切除术,n=36)和对照组(行VATS肺叶切除术,n=50),比较两组患者的手术相关指标(手术成功率、手术时间、术中出血量、术后胸腔引流量、淋巴结清扫数目和术后并发症发生率)、随访肺功能指标[用力肺活量(FVC)、1秒用力呼气容积(FEV1)和一氧化碳弥散量(DLCO)]和临床转归情况(无瘤生存期、复发率和总生存率)。结果两组患者的手术成功率、手术时间、术中出血量、术后胸腔引流量、淋巴结清扫组数和个数比较,差异均无统计学意义(P﹥0.05)。观察组患者的术后并发症总发生率低于对照组(P﹤0.05)。术后3个月,观察组患者的FVC、FEV1和DLCO值均高于对照组(P﹤0.05)。两组患者的无瘤生存期、复发率和总生存率比较,差异均无统计学意义(P﹥0.05)。结论VATS微创肺段切除术较VATS肺叶切除术的创伤更小,更有利于保护肺功能,在早期NSCLC的治疗中有较好的可行性和有效性。
Objective To investigate the feasibility and efficacy of video-assisted thoracoscopic surgery(VATS)segmentectomy in the treatment of early stage non-small cell lung cancer(NSCLC).Method A total of 86 consecutive patients with NSCLC were enrolled in the research as study group,receiving VATS segmentectomy(n=36),or control group that adopted VATS lobectomy(n=50),the surgical indicators(success rate of surgery,operative time,intraoperative hemorrhage,postoperative drainage volume,number of excised lymph nodes and incidence rate of postoperative complications),pulmonary function parameters[forced vital capacity(FVC),forced expiratory volume in one second(FEV1)and diffusing capacity of lung for carbon monoxide(DLCO)],and clinical outcomes(tumor-free survival,recurrence rate and overall survival rate)in the two groups were compared.Result The success rate of surgery,operative time,intraoperative hemorrhage,postoperative drainage volume,number of excised lymph nodes in the two groups were of no statistical differences(P>0.05).Whilethe overall incidence rate of postoperative complications in study group was significantly less than that in control group(P<0.05).Additionally,the values of FVC,FEV1 and DLCO at 3 months after surgery in study group were significantly higher compared to control group(P<0.05).Similar findings were observed in regard to the tumor-free survival,recurrence rate and overall survival rate in the two groups of patients(P>0.05).Conclusion Compared with VATS lobectomy,VATS segmentectomy may help preserve pulmonary functiondue to the minor wounds during surgery,demonstrating the feasibility and efficacy in the treatment of early stage non-small cell lung cancer.
作者
唱宽
毛志刚
舒健
CHANG Kuan;MAO Zhigang;SHU Jian(Department of Cardiothoracic Surgery,Northern Theatre Command Airforce Hospital of Chinese People’s Liberation Army,Shenyang 110042,Liaoning,China)
出处
《癌症进展》
2020年第6期606-609,共4页
Oncology Progress
关键词
电视胸腔镜手术
肺段切除术
肺叶切除术
非小细胞肺癌
肺功能
video-assisted thoracoscopic surgery
segmentectomy
lobectomy
non-small cell lung cancer
pulmonary function
