微创外科手术治疗早期肺癌

随着胸腔镜技术的不断发展和成熟,近20年来胸腔镜手术已成为早期肺癌外科治疗的主要术式。研究表明对于<3 cm的周围型肺癌进行胸腔镜肺叶切除,结果手术成功率、病死率、复发和生存,与常规开胸手术相比无明显差异,手术时间、术后合并症、1年生存等均未见明显差异。胸腔镜和传统手术方式的肺门及纵隔淋巴结清扫个数均无明显差异,对病灶直径 < 2 cm IA期非小细胞肺癌患者比较了胸腔镜肺段切除和肺叶切除,观察5年生存率(79.9% vs 81.0％)和无病存活率(59.4% vs 64.2％)无明显差异。近期达芬奇机器人系统进行肺叶切除是肺癌微创治疗的另一种新手段。

Minimally invasive surgery to treat early lung cancer

With the continuous development and maturity of video-assisted thoracoscopic technology, nearly 20 years of thoracoscopic operation has become the main mode of minimally invasive operation on early stage lung cancer. Studies show that for peripheral lung cancer less than 3 cm removed by video-assisted thoracoscopic(VATS) lobectomy, there were no significant differences in operation success rate, mortality, recurrence and survival, compared with conventional open surgeries, and operation time, postoperative complications, and 1 years survival rates had no significant differences. There were no significant differences between numbers of hilar and mediastinal lymph nodes dissected among VATS and conventional surgery groups. Comparing thoracoscopic segmentectomy with thoracoscopic surgery in patients with small-sized( < 2 cm) stage Ia non-small cell lung cancer, no significant difference was observed in 5-year overall survival(79.9% vs 81.0%) or disease-free survivals(59.4% vs 64.2%). Recently Da Vinci robotic system for lobectomy became another new method of minimally invasive treatment for lung cancer.