胸腔镜肺叶切除术治疗周围型非小细胞肺癌的疗效分析

目的：探讨胸腔镜肺叶切除术治疗周围型非小细胞肺癌的疗效，并与传统开胸手术方法进行比较。方法：回顾性分析2008年1月至2011年1月因非小细胞肺癌在我科接受手术治疗患者的临床资料，比较开胸手术组与胸腔镜组的手术时间、术中淋巴结清扫数目、术中出血量、术后引流量、术后拔管时间、术后住院时间等临床指标。结果：共纳入患者392例，开胸手术组214例，占54．59％，胸腔镜组1,78例，占45．41％。两组患者的术中淋巴结清扫数目、手术时间差异无统计学意义；胸腔镜组患者术中出血量显著少于开胸手术组患者（231．4±41．9）mlvs（165．3±31．2）ml，P〈0．05]，术后引流液量亦显著少于开胸手术组（640．0±69．0）mlvs（846．0±71．0）ml，P〈0．05]；胸腔镜组术后住院时间显著短于开胸手术组（8．1±2．1）vs（12．5±2．8）d，P〈0．05]，术后拔管时间显著早于开胸手术组（3．1±0．3）vs（4．4±0．5）d，P〈0．05]。结论：在周围型非小细胞肺癌的手术治疗中，胸腔镜手术可减少术中出血量，缩短术后康复时间，术中清扫淋巴结数目及手术时间与传统开胸手术并无显著性差异，是一种安全、有效的肺癌手术治疗方式。

The clinical effect of thoracoscopic lobectomy for patients with non-small cell lung cancer

Objective： To study the clinical effect of thoracoscopic lobectomy for patients with non-small cell lung cancer（NSCLC）. Methods： Clinical data of patients underwent thoracoscopic lobectomy for NSCLS at our hospital 2008 to 2011 was collected. The time of operation, the number of lymph node dissection, intraoperative blooding, postoperative chest drainage , the time of extracting drainage tube and postoperative hospital stay were compared between the two groups retrospectively. Results： A total of 392 patients were analyzed, thoracotomy group was 214 cases, accounting for 55.7%, thoracoscopy group was 178 cases, accounting for 46.4%. There were no significant difference in time of operation, the number of lymph node dissection between the two groups. The intraoperative blooding, postoperative thoracic drainage, the time of extracting drainage tube and postoperative hospital stay ofthoracoscopy group were all less than those in thoracotomy group （P 〈 0. 05 ）. Conclusion： Thorac-oscopic lobectomy is a safe and effect surgical method for patients with NSCLC.