魏崴,李勇生,钟标,黎佩建
WEI Wei,LI Yongsheng,ZHONG Biao,LI Peijian

• 1:惠州市中心人民医院

摘要(Abstract)：

目的:探讨全胸腔镜肺叶切除手术治疗直径>5 cm的非小细胞肺癌(NSCLC)的可行性。方法:选择肿瘤直径>5 cm的NSCLC患者53例,观察组29例行全胸腔镜肺叶切除手术(VATS)治疗,对照组24例行开胸手术(TOS)治疗,比较两组患者围手术期资料及术后并发症,随访观察两组患者1年、3年复发率和生存率。结果:观察组与对照组比较,术后引流时间和住院时间短,失血量和引流量少,术后VAS评分低,差异有统计学意义(t1=19.192,t2=7.245,t3=28.362,t4=26.344,t5=7.448,P<0.05);观察组术后并发症发生率为17.24%,对照组为16.67%,两组比较差异无统计学意义(χ2=1.221,P>0.05);观察组与对照组术后1年复发率、生存率分别为(10.35%vs.8.33%)、(96.6%vs.95.8%),3年复发率、生存率分别为(34.48%vs.33.33%)、(72.41%vs.75%),差异均无统计学意义(P>0.05)。结论:全胸腔镜肺叶切除术治疗直径大于5 cm NSCLC具有创伤小,安全可行,可取得与TOS治疗同样的近期和远期疗效。
Objective: To investigate the feasibility of full thoracoscopic lobectomy( VATS) treatment on tumor diameter greater than 5 cm in non-small cell lung cancer( NSCLC). Methods: Fiftythree cases of NSCLC patients of tumor diameter larger than 5 cm were selected,29 cases as the observation group were given VATS treatment,24 cases as control group were given thoracotomy( TOS)treatment. Comparing perioperative data,complications and one-year,three-year recurrence rate and survival rate of both groups. Results: The observation group exhibited shorter drainage time,shorter hospital stay,less blood loss,less drainage volume,lower postoperative VAS scores,the differences were statistically significant( t1= 19. 192,t2= 7. 245,t3= 28. 362,t4= 26. 344,t5= 7. 448,P <0. 05); postoperative complications occurred in observation group was 17. 24%,the control group was16. 67%,the difference was not statistically significant( χ2= 1. 221,P > 0. 05); one-year recurrence rate after surgery,survival rate of the observation group and control group were( 10. 35% vs 8. 33%)and( 96. 6% vs 95. 8%); three-year recurrence rate,survival rate were( 34. 48% vs 33. 33%) and( 72. 41% vs 75%),there was no significant difference( P > 0. 05). Conclusions: Full thoracoscopic lobectomy treatment on tumor diameter greater than 5 cm in NSCLC is safe and feasible,which can achieve the same short-term and long-term curative efficacy.

关键词(KeyWords)： 胸腔镜;胸外科手术;癌,非小细胞肺;手术后并发症
thoracoscopes;thoracic surgical procedures;carcinoma;non-small cell-lung;postoperative complications

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 魏崴,李勇生,钟标,黎佩建
WEI Wei,LI Yongsheng,ZHONG Biao,LI Peijian

DOI: 10.19367/j.cnki.1000-2707.2015.04.019

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