电视胸腔镜肺叶切除术临床疗效分析

目的探讨电视胸腔镜肺叶切除术临床疗效,为胸腔镜手术临床推广提供参考。方法回顾性分析上海市肺科医院2004年1月至2009年6月胸腔镜肺叶切除术患者的临床资料,筛选胸腔镜肺叶切除术临床疗效的影响因素。结果入选病例516例,男性282例(54.7%),女性234例(45.3%),年龄35～70岁,平均(55.9±8.1)岁。术后348例(67.4%)病理诊断为恶性病变,168例(32.6%)为良性病变。48例(9.3%)患者出现术后并发症,死亡4例(0.8%)。23例(4.6%)患者术中转为常规开胸手术。手术时间(P=0.0257,OR=1.0150,95%CI1.0018～1.0284)是影响术后并发症发生率的唯一独立危险因素。对其中2004年1月至2008年12月266例行胸腔镜肺叶切除术的非小细胞肺癌患者进行生存分析,结果发现术后1、3、5年生存率分别为91.3%、76.5%、54.7%。结论对需手术治疗的肺部疾病患者而言,胸腔镜肺叶切除术是一种安全的治疗手段;胸腔镜肺叶切除术治疗肺癌,同样具有微创优势,但患者选择十分重要。胸腔镜手术应注意控制手术持续时间,否则将增加术后并发症的发生率。

Video-assisted thoracic surgery lobectomy:an analysis of clinical effectiveness of 516 cases

Objective To analyze the clinical effectiveness of video-assisted thoracic surgery(VATS)lobectomy,so as to provide evidence for its popularization in clinical practice.Methods The clinical data of patients who received VATS lobectomy from January 2004 to June 2009 were retrospectively analyzed,so as to screen for the factors influencing the effectiveness of VATS.Results A total of 516 patients who received VATS lobectomy at Shanghai Pulmonary Disease Hospital were included in the present study;the patients ...