肌肉非损伤性开胸气道重建治疗中心型NSCLC

目的探讨肌肉非损伤性开胸术气道重建治疗中心型非小细胞肺癌的可行性及临床效果。方法观察组16例患者采用左或右胸侧胸壁肌肉非损伤性开胸术,切口长约9～15cm。对照组21例患者采用左或右胸标准后外侧剖胸切口,长约25～35cm,并剪断一根后肋。比较两组开胸时间、关胸时间、手术时间、术中出血量、术后住院日、术后并发症等。结果观察组开胸时间、关胸时间、术后住院日明显短于对照组,差异有统计学意义(P<0.05);观察组术后并发症明显少于对照组,差异有统计学意义(P<0.05);观察组术中出血量较对照组减少,但差异无统计学意义(P>0.05);观察组手术时间较对照组短,但差异无统计学意义(P>0.05)。结论采用肌肉非损伤性开胸术对局部晚期中心型非小细胞肺癌行气道重建,能提供充分的手术暴露,不损伤肌肉,并发症少、恢复快,同时兼顾美观。术前充分准备,术中采用单手及加长器械操作并利用冷光源协助照明可保证手术顺利进行。

Muscle-sparing thoracotomy on airway reconstruction for central NSCLC

Objective To discuss the feasibility and clinic effect of muscle-sparing thoracotomy on airway reconstruction treating central non-small cell lung cancer.Methods MST group:16 cases received left or right lateral thoracic MST with 9-15cm.Control group:21 cases received left or right standard posterolateral thoracotomy with 25-35cm and one posterior segment of rib was cut.The time of thoracotomy and close,the time of the surgery,the amount of hemorrhage during the surgery,the days of postoperative hospitalization and the postoperative complications were compared between the two groups.Results The time of thoracotomy and close,the days of postoperative hospitalization of MST group is obviously shorter than that of control group respectively(P < 0.05);The postoperative complications in MST group are less than that in control group(P < 0.05);The amount of hemorrhage and time of the surgery in MST group has no significant difference than that in control group(P > 0.05).Conclusion Proper airway reconstruction treating local late NSCLC by MST,which can give sufficiency surgery exposure without muscular damage,reduce the postoperative complications,reduce the time of recovery,and achieve good cosmetic results.Good preparation before operation,performing the surgery with extra-long instruments,using the cold light source will make sure the surgery be done smoothly.