肺癌切除术中胸腔镜辅助小切口下淋巴结清扫的效果评价

CLINICAL STUDY OF LYMPHADENECTOMY WITH VIDEO-ASSISTED MINI-THORACTOMY SURGERY FOR LUNG CANCER PATIENTS

[目的]探讨胸腔镜辅助小切口下(VAMT)淋巴结清扫的可行性。[方法]电视胸腔镜辅助小切口下肺叶切除、淋巴结清扫术,随后将小切口延长为常规后外侧开胸切口,直视下淋巴结清扫。从2006年10月～2007年4月共进行该手术12例,比较两种手术方式清扫淋巴结的个数及转移阳性的淋巴结数(以常规开胸手术为标准)。所有病例术前征得病人及家属的同意。[结果]12例肺癌病人共切除淋巴结138枚,其中VAMT切除134枚,阳性淋巴结49枚。随后常规开胸共切除4枚。两组淋巴结总数和阳性淋巴结数无显著差异。[结论]对于早期肺癌,VAMT淋巴结清扫可取得和常规开胸相当的效果,为肺叶或全肺切除、淋巴结清扫提供了一种可供选择的方法。

[ Objective] To evaluate the feasibility of pulmonary resection by video-assisted mini-thoractomy （VAMT） for patients with lung cancer. [Methods] From October of 2006 to April of 2007, radical lobectomy or pneumonectomy and systemic lymphadenectomy were preformed on 12 patients with lung cancer through VAMT at first, and then lymphadenectomy were done again through routine thoractomy, the number of lymphnodes and positive lymphnodes in the groups were compared. [Results] 138 lymph-nodes were resected on the 12 patients with lung cancer, 134 within 49 positive lymph-nodes were resected by VAMT, afterward 4 lymph-nodes were resected in general thoractomy . There was no significant difference in the total lymph-node number and positive lymph-node number between the two groups. [Conclusion] In the early stage of lung cancer, VAMT lymphadenectomy should fulfill the same quality as routine thoractomy.