从清扫淋巴结角度看胸腔镜辅助手术在肺癌治疗中的应用

背景与目的：电视胸腔镜辅助小切口作为一种微创手术径路,其能否完成标准肺癌根治术一直是胸科医师争论的焦点。本研究从清扫淋巴结角度探讨传统切口与电视胸腔镜辅助小切口在肺癌根治术中的应用。方法：选取2001年1月—2005年12月的549例肺癌患者,所选病例均行电视胸腔镜辅助小切口肺癌根治术,统计各病例术后胸内清扫淋巴结数,并计算各组淋巴结的清扫数目、平均每例淋巴结清除数等。收集有关系统胸内淋巴结清扫、胸腔镜辅助肺叶或（左或右）全肺切除等资料,进行淋巴结清扫对比研究。结果：549例共清扫淋巴结7360个,平均每例清扫淋巴结数13．41个,与传统切口开胸清扫淋巴结数对比,差异无显著性。结论：电视胸腔镜辅助小切口可以完成同质量的系统性胸内淋巴结清扫．并能规范的完成肺痛根治术。

Application of video-assisted thoracospic surgery for lung cancer as viewed via lymphadenectomy

Background and purpose:As a minimally invasive procedure, video-assisted thoracospic surgery for definitive resection of lung cancer is the focus of thoracic surgeons controversy.We studied the application of video-assisted thoracospic surgery and conventional thoracotomy for definitive resection of lung cancer from viewpoint of lymphadenectomy. Methods:From January 2001 to December 2005,549 patients with lung cancer underwent video-assisted thoracospic surgery lobectomy or pneumonectomy with systematic thoracic lymphadenectomy. The total number and average of dissected lymph nodes were recorded. Some studies on VAT and conventional lobectomy or pneumonectomy with systematic thoracic lymphadenectomy for lung cancer were compared.Results:In all 549 cases,7360 lymph nodes were dissected. The average of dissected lymph nodes was 13.41. There were no significant difference between video-assisted thoracospic surgery and conventional thoracotomy.Conclusions:Video-assisted thoracospic surgery should fulfill the same quality of lymphadenectomy WT5"and lung cancer radical resection. WT5"HZ