全腔镜肺癌根治术与普通剖胸肺癌根治术的对比研究

目的 对比分析全胸腔镜肺癌根治术和常规剖胸肺癌根治术对非小细胞肺癌的近远期疗效及安全性,旨在为今后合理选择手术方案提供参考和借鉴.方法 前瞻性选取本院胸外科2013年1月至2016年1月期间60例确诊为非小细胞肺癌患者,采用随机数字表法将其分为两组,每组30例,剖胸组行常规剖胸肺癌根治术,胸腔镜组行全胸腔镜肺癌根治术,对比分析两组患者手术情况、术后并发症及无瘤生存情况.结果 剖胸组手术成功率为100.00％,胸腔镜组中9例延长切口后完成手术,无中转剖胸手术者;胸腔镜组切口长度、开关胸时间、术中出血量、引流管放置时间、住院时间均明显小于剖胸组(P＞0.05),胸腔镜组手术时间明显长于剖胸组(P＜0.05),两组在淋巴结清扫数方面相近,差异无统计学意义(P＞0.05);胸腔镜组并发症发生率为10.00％,明显低于剖胸组的33.33％ (P＜0.05);胸腔镜组无瘤生存率为96.67％,明显高于剖胸组的80.00％ (P＜0.05).结论 全胸腔镜手术可完成解剖性肺叶切除和系统性淋巴结清扫,达到标准肺癌根治术的要求,且创伤小、恢复快、安全性高,可作为首选的手术方案.

Thoracoscopic versus open chest radical resection of pulmonary carcinoma

Objective To analyze the long term efficacy and safety of thoracoscopic versus open chest radical resection of non-small cell lung cancer and to provide some references for rationally choosing surgical procedure.Methods 60 patients diagnosed with non-small cell lung cancer at our department from January,2013 to January,2016 were prospectively chosen and randomly divided into an open chest group and a thoracoscopic group,30 for each group.The open chest group were treated with open chest radical resection of pulmonary carcinoma and the thoracoscopic group with thoracoscopic radical resection.The status of surgical,complications,and tumor-free survival were compared between these two groups.Results The success rate of the open ches group was 100.00％.The incisions of 9 patients in the thoracoscopic group had to be extended to finish the surgery.No case was converted to open chest surgery in the thoracoscopic group.The incision length chest-opened,-closed time,time for drainage tube placement,and hospital stay were shorter,the bleeding volume was lower,and the operation time was longer in the thoracoscopic group than in the open chest group,with statistical differences (P＜0.05).There was no statistical difference in lymph node dissection between these two groups (P ＞ 0.05).The incidence of complications and tumor-free survival rate were 10.00％ and 96.67％ in the thoracoscopic group and were 33.33％ and 80.00％ in the open chest group (P ＜ 0.05).Conclusions Totally thoracoscopic surgery can complete anatomical lobectomy and lymph node dissection and is up to the standard of the radical surgery of lung cancer,minimally invasive,fast recovery,and safe,so it is a first choice of surgical treatment.