微创手术根治肺癌疗效分析

目的：探讨电视胸腔镜手术（VATS）、胸腔镜辅助小切口手术（VAMT）、小切口开胸手术（MT）手术的创伤程度,为肺癌根治微创术式选择提出依据。方法：回顾性分析我院34例VATS、35例VAMT、35例MT肺癌根治术患者手术时间、术中失血量、切除淋巴结数、累计胸腔引流量、术后止痛药用量、术后2周时肩关节活动受限例数。结果：VATS、VAMT、MT组间手术时间、切除淋巴结数差异无显著性（P〉0.05）,术中失血量、累计胸腔引流量、术后止痛药用量差异有显著性（P〈0.05）,MT组大于VATS和VAMT组。三组间术后肩关节活动受限例数差异无显著性（P〉0.05）,但MT组的发生率明显高于其他两组。结论：针对Ⅰ～Ⅱa期肺癌采用VATS术式,Ⅱb～Ⅲ期肺癌采用VAMT术式,但为了保证手术安全,应首选最擅长的微创术式。

Analysis of minimally invasive lobectomy in the treatment of lung cancer

Objective： To study the trauma of three minimally invasive surgeries for lung cancer comparatively, and to provide the suggestion for selection of the three minimally invasive surgeries. Methods： Thirty-four patients treated with VATS,thirty-five patients with VAMT and thirty-five patients with MT were retrospectively studied,the operative duration,the blood loss,the chest drainage,the number of lymph node dissected,the dosage of analgesic and the number of shoulder function limitation after operation 2 weeks were analyzed. Results： Although there was no significant difference between the operative duration and the number of lymph node dissected in VATS,VAMT and MT groups,the blood loss,the chest drainage and the dosage of analgesic in MT group were more than those of VATS and VAMT groups（ P 0. 05） . There was no significant difference in the number of shoulder function limitation in three groups,however,the morbidity of shoulder function limitation in MT group was higher than the other two groups. Conclusion： The clinical stage Ⅰ-Ⅱa lung cancer should be treated with VATS and the clinical stage Ⅱb-Ⅲ lung cancer should be managed with VAMT,but the operator should choose the most effective method to treat lung cancer for safety.