胸腔镜肺叶切除术与胸腔镜亚肺叶切除术治疗早期非小细胞肺癌的对比研究

目的:探究胸腔镜亚肺叶切除术在早期非小细胞肺癌（non-small cell lung cancer,NSCLC）中的应用价值。方法:回顾性选取2014年1月至2018年7月于我院胸外科确诊并行胸腔镜手术治疗的247例早期NSCLC患者资料进行研究。根据手术方式不同将129例接受胸腔镜肺叶切除术患者设为肺叶切除组，将118例接受胸腔镜亚肺叶切除术患者设为亚肺叶切除组。采用统计软件SPSS 19.0录入分析数据，对比两组患者围手术期指标、肺功能指标、术后并发症及短期复发情况。结果:亚肺叶切除组患者年龄、术前合并症例数大于肺叶切除组（P＜0.05）。手术时间、术中出血、胸腔引流时间及术后卧床时间优于肺叶切除组（P＜0.05），清扫淋巴结数目、术后住院时间及术后并发症方面两组差异无统计学意义（P＞0.05）。术后两组患者FEV1%、MVV%、FVC%较术前相比显著降低（P＜0.05），亚肺叶切除组FEV1%、MVV%、FVC%整体情况优于肺叶切除组（P＜0.05）。两组术后1年内均无复发、死亡病例出现。结论:胸腔镜下亚肺叶切除术创伤小、出血少、恢复快，对肺功能保留有重要意义，且对于高龄、术前合并基础病的早期NSCLC患者更具优势。

A comparative study between thoracoscopic lobectomy and thoracoscopic sublobectomy in the treatment of early stage non-small cell lung cancer

Objective:To explore the value of thoracoscopic sublobectomy in the early stage of non-small cell lung cancer (NSCLC).Methods:Data of 247 patients with early NSCLC diagnosed by thoracoscopic surgery in our hospital from January 2014 to July 2018 were retrospectively selected for study.According to different surgical methods,129 patients who received thoracoscopic lobectomy were assigned to the lobectomy group,and 118 patients who received thoracoscopic sublobectomy were assigned to the sublobectomy group.Statistical software SPSS 19.0 was used to enter the analysis data,and the perioperative indicators,pulmonary function indicators,postoperative complications and short-term recurrence were compared between the two groups.Results:The age and number of complications in sublobectomy group were higher than those in lobectomy group (P＜0.05).The operative time,intraoperative hemorrhage,chest drainage time and postoperative bed rest time were better than the lobectomy group (P＜0.05),and there was no statistical difference in the number of lymph nodes dissected,postoperative hospital stay and postoperative complications between the two groups (P＞0.05).FEV1%,MVV% and FVC% in the two groups were significantly lower than that before surgery (P＜0.05).The overall FEV1%,MVV% and FVC% in the sublobectomy group were better than those in the lobectomy group (P＜0.05).No recurrence or death occurred in both groups within 1 year after surgery.Conclusion:Thoracoscopic sublobectomy has less trauma,less bleeding and faster recovery,which is of great significance for the preservation of lung function,and is more advantageous for the elderly patients with early NSCLC combined with basic diseases before surgery.