胸腔镜下肺叶切除治疗早期非小细胞肺癌45例的临床分析

目的对比分析胸腔镜肺叶切除术(VATS)与常规开胸肺叶切除术(CT)在治疗早期非小细胞肺癌的优越性。方法收集我科2010年1月至2014年12月所开展的45例胸腔镜肺叶切除术(VATS)与45例传统开胸肺叶切除术(CT)在治疗早期非小细胞肺癌方面做对照研究,就两组术中所用时间,术中出血量、切口长短、淋巴结清扫数目、胸腔引流管保留时间、术后胸腔积液引流量、切口疼痛程度、术后并发症、术后住院天数,以及肿瘤坏死因子(TNF-α)、白介素1β(IL-1β)、C反应蛋白(CRP)指标差异性进行对比分析。结果VATS组中在术中所用时间、切口长度、术中出血量、胸腔引流管保留时间、术后胸腔积液引流量、以及术后住院天数,明显优于CT组,VATS组术后1、3、5天切口疼痛程度、血清TNF-α、IL-1β及CRP水平均明显低于同时间点CT组(P均0.05),但术后并发症及淋巴结清扫数量组间无差异(P均0.05)。结论胸腔镜肺叶切除术在治疗早期非小细胞肺癌中是一种安全有效并且更加微创的手术方式,值得推广。

Clinical analysis between video-assisted thoracoscopic lobectomy and conventional thoracotomy for 45 pa- tients with non-small cell lung cancer

Objective To evaluate the clinical effect between video-assisted thoracic surgery(VATS)and conventional thoracotomy(CT)in the treatment of non-small cell lung cancer(NSCLC). Methods 45 cases under-went video-assisted thoracic surgery(the VATS group)and 45 cases underwent conventional thoracotomy(the CT group)were compared in operation time, the number of lymph node, intraoperative blood loss, chest tube conduc-tion, postoperative chest tube time, postoperative hospital stay, incision pain, complications, tumor necrosis factorα(TNF-α), interleukin 1β(IL-1β)and C reaction protein(CRP)etc. Results The operation time, intraoperative blood loss, chest tube time, chest tube conduction, incision pain and postoperative hospital stay were significantly lower in the VATS group than in the thoracotomy group, and similar tendencies in TNF-α, IL-1βand CRP were ob-served at Day 1, 3 and 5(P<0. 05, respectively). There was no significant difference in postoperative complica-tions and the number of lymphnode between the two groups(P>0. 05, respectively). Conclusion Video-assisted thoracic surgery is a safe and effective surgical procedure with minimal invasiveness in the treatment of pulmonary dis-eases.