全腔镜肺叶切除与开胸肺叶切除治疗早期肺癌的初步体会

【摘要】〓目的〓通过两种术式的比较,评价完全胸腔镜下肺叶切除治疗早期肺癌临床疗效。方法〓回顾分析性分析2012年9月至2013年05月我科行全腔镜下肺叶切除35例术前分期为pT1N0-1M0肺癌患者的资料(VATS组),全组病例均采用全腔镜四孔法完成手术。选取同期行常规开胸手术35例术前分期pT1N0-1M0肺癌患者的临床资料作为对照。比较两组之间手术时间,术中出血量,术后拔管时间,淋巴结清扫数目,术后疼痛,术后并发症发生率,术后住院时间等指标。结果〓无围手术期死亡,VATS组1例患者中转开胸。VATS组患者的术中出血量、引流时间、术后疼痛时间以及住院时间均明显低于常规开胸组患者(P<0.05);VATS组的手术时间、淋巴结清扫数与对照组的差异无统计学意义。结论〓全腔镜肺叶切除治疗早期肺癌安全可行,临床疗效满意。

Preliminary experience in completely video-assisted thoracoscopic lobectomy and open thoracoscopic lobectomy in treatment of early-stage lung cancer

Objective To evaluate the clinical efficacy of the completely video-assisted thoracoscopic lobectomy for early lung cancer. Methods A retrospective analysis was performed in 35 lung cancer patients who underwent completely video-assisted thoracoscopic lobectomy（VATS group）from Sep 2012 to May 2013. Another 35 selective cases with lung cancer who received open lobectomy were served as controls. Operating time, intraoperative bleeding and postoperative extubation time,number of lymph node dissection, postoperative pain, postoperative complications, postoperative hospitalization time were compared between VATS group and control group. Results No death occurred in peri-operative period, and one case was converted to open surgery. In VATS patients,blood loss, retention time of drainage tube, postoperative pain duration, hospital stay were shorter than that in controls（P0.05）. The average operation time, average number of lymph node dissection in VATS patients were similar to that in controls. Conclusion Completely video-assisted thoracoscopic lobotomy has an advantage open operation over for treating early lung cancer.