早期非小细胞肺癌外科治疗进展

 外科手术是早期肺癌治疗的首选。肺癌的标准术式是肺叶切除加淋巴结清扫。但淋巴结清扫对肺癌的治疗作用尚存争议。近年来以胸腔镜为代表的微创胸外科技术在临床广泛开展，胸腔镜肺叶切除的安全性已得到认可，但用于肺癌的外科治疗是否能达到如同开胸手术一样的功效，尚未达成共识。医学影像技术进步使更多的早期肺癌得以被发现，对于直径小于2 cm的周围型肺癌，肺段切除或楔形切除能否取代肺叶切除成为此类型肺癌的标准手术方式，还有待新的证据出现。

Surgical progress on early stage non-small call lung cancer

Surgical resection (usually lobectomy) is considered the treatment option for individuals with stage Ⅰ and Ⅱ non-small cell lung cancer. The surgical treatment of stage Ⅰ and Ⅱ non-small cell lung cancer (NSCLC) continues to evolve in the areas of intraoperative lymph node staging (specifically the issue of lymph node dissection vs sampling), the role of sublobular resections instead of lobectomy for treatment of smaller tumors (especially peripheral carcinoma ≤2 cm in diameter), and the use of video-assisted techniques to perform anatomic lobectomy. Video-assisted thoracic surgery (VATS) lobectomy provides a minimally invasive approach for the management of early-stage lung cancer. Questions about the safety of VATS lobectomy and its adequacy as a cancer operation compared with open thoraeotomy have hindered its universal acceptance among thoracic surgeons. Evidence suggests that VATS lobectomy can be safely performed and is an adequate cancer operation for early-stage NSCLC. Recently, robots have been introduced into surgical procedures in an attempt to facilitate surgical performance. However, adequately powered well-balanced studies comparing VATS with open thoracotomy for lobectomy are lacking in the literature.