胸腔镜肺亚叶切除术治疗I期高龄非小细胞肺癌患者的回顾性研究

目的探讨胸腔镜肺亚叶切除术治疗I期高龄非小细胞肺癌患者的临床疗效。方法将行手术治疗且术后病理为I期非小细胞肺癌的126例年龄＞70岁的患者分为胸腔镜肺亚叶切除术组（59例）和胸腔镜肺叶切除术组（67例），分析比较两组患者的年龄分布情况、术后并发症、术后引流时间、住院天数及术后随访情况。结果＞75岁患者多选择胸腔镜肺亚叶切除术。胸腔镜肺叶切除术患者总体并发症发生率（40.7%）显著高于胸腔镜肺亚叶切除术患者（19.4%），差异有统计学意义（P=0.047）。胸腔镜肺亚叶切除术患者的平均术后引流时间、住院天数（3.3±1.0）d、（8.5±1.5）d]短于胸腔镜肺叶切除术患者（4.4±2.0）d、（12.8±2.0）d]，差异均有统计学意义（均P＜0.01）。两组患者2、3年生存率的差异均无统计学意义（均P＞0.05）。结论胸腔镜肺亚叶切除术治疗老年I期非小细胞肺癌安全性良好，预后与肺叶切除术相似，可以作为老年I期非小细胞肺癌患者尤其是不能耐受肺叶切除者一个较好的选择。

Thoracoscopic sublobar resection in elderly patients with stage I non-small cell lung cancer

Objective To evaluate the efficacy of thoracoscopic sublobar resection in elderly patients with stage I non- smal celllung cancer （NSCLC）. Methods One hundred and twenty six patients with stage I NSCLC aged＆gt;70y underwent thoracoscopic resection in our hospital between October 2008 and October 2011, including 67 cases with thoracoscopic sublo-bar resection （study group）, and 59 cases with thoracoscopic lobectomy （control group）. The age distribution, postoperative complications, chest tube maintenance time, length of hospital stay and the fol ow- up data were retrospectively reviewed and compared between two groups. Results Patients aged＆gt;75y were more likely to choose sublobar resection. The total compli-cation rate in control group was significantly higher than that in study group （40.7%vs 19.4%, P=0.047）. The chest tube mainte-nance time and length of hospital stay was longer in control group than in those study group （4.4±2.0d vs 3.3±1.0d, and 12.8± 2.0d vs 8.5±1.5d, respectively;both P〈0.01）. There was no significant difference in estimated 2- and 3- year survival rate be-tween two groups （P＆gt;0.05）. Conclusion Thoracoscopic sublobar resection can be performed safely in elderly patients with stage I NSCLC and the clinical efficacy is comparable with the thoracoscopic lobectomy.