电视胸腔镜手术在非小细胞肺癌治疗中的优势

目的探讨电视胸腔镜手术（VATS）相对于传统开胸手术在非小细胞肺癌（NSCLC）诊断和治疗中的优势。方法收集2008年11月至2010年11月行全胸腔镜肺叶切除术患者83例，并与同期97例行传统开胸肺叶切除术的患者进行比较，术前患者均行胸部CT等常规检查临床诊断为NSCLC，观察两组患者的术中出血量、手术时间、淋巴结清扫数目、术后胸腔闭式引流天数、术后住院时间，并将数据输入SPSS17．0统计软件包，计算两组均数±标准差（x±S），统计方法采用两样本均数t检验，P≤0．05为差异有统计学意义。结果VATS组在平均术中出血量、淋巴结清扫数目、术后胸腔闭式引流天数方面与传统开胸组比较无统计学差异，而平均手术时间多于传统开胸组，术后平均住院时间少于传统开胸组，差异具有统计学意义。结论VATS在与传统开胸手术治疗NSCLC相比，其能达到相似的手术效果，并能明显减少术后并发症及术后住院时间，将手术创伤降至最低，提高患者术后生存质量。虽然有关VATS与传统手术术后生存效果的比较有待多中心、长期大宗完整病例的观察和分析。但有理由相信VATS应用前景将会更加广阔。

Advantages of video-assisted thoracic surgery in the treatment of non-small cell lung cancer

Objective To investigate the advantages of video-assisted thoracoscopic surgery(VATS) compared with conventional thoracotomy in the diagnosis and treatment of non-small cell lung cancer (NSCLC). Methods From Nov. 2008 to Nov. 2010, 180 NSCLC patients were collected, 83 patients underwent VATS, 97 patients underwent conventional thoracotomy lobectomy. All the patients underwent preoperative chest CT checking for clinical diagnosis of NSCLC, and were observed with blood loss of operation, operative time, number of lymph node dissected, days of postoperative chest tube drainage, postoperative hospital stay, and the data were input into SPSS17.0 statistical package, calculated the two groups mean ± standard deviation (x±s), statistical methods was two sample t test,P≤0.05 was considered statistically significant. Results In VATS group, the average blood loss of operation, number of lymph node dissected, days of postoperative chest tube drainage were no significant difference compared with conventional thoracotomy, while the average operating time was more than conventional thoracotomy group, mean postoperative hospital stay was less than conventional thoracotomy group, the difference was statistically significant. Conclusion VATS in the treatment of NSCLC achieved a similar effect compared with conventional thoracotomy and significantly reduce postoperative complications and postoperative hospital stay, minimized the surgical trauma and improved the patients quality of life. Although the comparing of long time postoperative survival effect for VATS and conventional thoracotomy needed multi-center, large long-term observation and analysis of complete cases, there were reasons to believe that VATS would be more broad used in the future.