非小细胞肺癌伴纵隔淋巴结肿大胸腔镜下纵隔淋巴结清扫的探讨

目的 探讨非小细胞肺癌胸腔镜肺叶切除术与常规开胸肺叶切除术的淋巴结清扫差异.方法 收集我院确诊的非小细胞肺癌伴纵隔淋巴结肿大（直径≥0.5 cm）的患者98例,其中胸腔镜肺叶切除术40例,常规开胸肺叶切除术58例,术后两周均行PET-CT检查并明确纵隔淋巴结有无阳性.采用卡方检验分析两组术后淋巴结的清扫有无差异.结果 PET-CT检查结果提示胸腔镜肺叶切除术组术后的纵隔淋巴结阳性率为7.50%（3/40）,常规开胸肺叶切除组术后的纵隔淋巴结阳性率为5.17%（3/58）.两组术后淋巴结清扫比较无统计学差异（P＞0.05）.结论 胸腔镜肺叶切除术能够让非小细胞肺癌伴纵隔淋巴结肿大的患者取得与常规开胸肺叶切除术同样的效果.同时胸腔镜手术具有微创,术后恢复快等优点.

Discussion of lymph nodes scavenge for patients with non-small cell lung carcinoma complicated with mediastina lymphadenectasis under thoracoscope

Objective To discuss the effect of non-small cell lung carcinoma lymph nodes scavenge between thoracoscope lobecto- my of lung and common lobectomy of lung. Methods 98 patients with non-small cell lung carcinoma complicated with mediastina lymph- adenectasis （diameter ≥0.05 cm） were collected in our hospital, 40 of whom were given thoracoscope lobectomy of lung and another 58 patients were given common lobeetomy of lung. PET-CT examination was done for 98 patients two weeks after the operation. The difference of lymph nodes scavenge between the two groups were analyzed by chi-square test. Results The results of PET-CT showed that the posi- tive expression of mediastina lymphadenectasis was 7.50% in the thoracoscope lobectomy of lung group and 5. 17% in the pulmonary lo- bectomy group respectively, which showed no statistical significance between the two groups. Conclusion Lobectomy of lung under thora- coscope has the similar curative effect with common pulmonary lobectomy in the treatment of patients with non-small cell lung carcinoma complicated with mediastina lymphadenectasis, but the former has the advantages of minimal trauma and quick recovery.