完全胸腔镜与传统开放肺叶切除术对非小细胞肺癌患者围手术期影响的比较

目的:比较完全胸腔镜与传统开放行非小细胞肺癌肺叶切除术对患者围手术期临床疗效?创伤及急性期反应?方法:将40例非小细胞肺癌患者分为完全胸腔镜手术(VATS)组和传统开放手术(TOS)组,每组20例?比较肺叶切除术围手术期临床疗以及血浆游离DNA浓度和血清C反应蛋白(CRP)水平,并进行统计分析?结果:两组无死亡病例,均未出现术后不良并发症,VATS组无中转开胸?两组的手术时间?清扫淋巴结站数及个数?术后引流时间?引流量无统计学差异(P > 0.05)?VATS组的术中失血量?术后疼痛评分?术后下床活动日?术后住院天数明显低于TOS组,有统计学差异(P < 0.05)?两组术前血浆DNA浓度和CRP水平无统计学差异(P > 0.05),术后第1?3和5天各时间点VATS组血浆DNA浓度和CRP水平均明显低于同时间点TOS组(P < 0.05)?结论:完全胸腔镜下非小细胞肺癌肺叶切除术与传统开放手术相比,围手术期疗效没有明显差异,却明显减轻了对机体的创伤?急性期反应和病人的痛苦,具有明确的微创性?

Comparison of the perioperative effect of lobectomy between totally video-assisted thoracoscopic surgery and traditional open surgery on non-small cell lung cancer

Objective:To compare the clinical efficacy,the injury and the acute phase reaction in perioperative period of lobectomy between totally video-assisted thoracoscopic surgery(VATS)and traditional open surgery(TOS)in non-small cell lung cancer(NSCLC)patients. Methods:Forty cases of NSCLC undergone lobectomy were enrolled in this study,including 20 treated by VATS and 20 by TOS. The clinical efficacy and the concentration of plasma DNA and CRP level in perioperative period were compared and analyzed statistically. Results:The surgeries in both groups were all successful. No death and no postoperative complication occurred. There was no difference in the operation time,the groups and the numbers of the lymph node cleaned and the time and volume for chest drainage between two groups(P > 0.05). The average bleeding volume during operation,the postoperative pain and the day of out-of-bed activity and hospitalization stay after operation were significantly lower in VATS group than in TOS group(P < 0.05).The concentrations of plasma DNA and CRP level were not different between two groups before the operation(P > 0.05). The concentrations of plasma DNA and CRP level were significantly lower in VATS group than those in TOS group in postoperative 1 day,3 day and 5 day(P < 0.05). Conclusion:Compared with TOS,VATS has no diffience in clinical efficacy in perioperative period,but can significantly decrease injury severity,acute phase reaction and the pain of the patients,and has obvious advantages of minimal invasion to patients.