摘要
目的探讨电视胸腔镜辅助胸壁小切口肺癌根治术的临床效果。方法比较2003年1~6月我院36例电视胸腔镜辅助胸壁小切口行肺癌根治术(胸腔镜组)与30例常规开胸行肺癌根治术(开胸组)手术及生存情况。结果胸腔镜组手术时间(114.6±47.4)min与开胸组(123.3±43.9)min无统计学差异(t=-0.768,P=0.449);胸腔镜组住院时间(9.2±1.4)d明显短于开胸组(10.5±1.7)d(t=-3.408,P=0.001);采用log-rank检验法比较胸腔镜组与开胸组生存曲线无统计学差异(χ2=0.270,P=0.605);COX回归分析显示病理类型(相对危险度3.912,P=0.000)、pTNM分期(相对危险度3.737,P=0.000)及淋巴结转移(相对危险度15.495,P=0.000)是影响非小细胞肺癌术后生存的危险因素,选用何种手术切口与预后无关(P=0.414)。结论电视胸腔镜辅助胸壁小切口肺癌根治术安全、可靠,可取得满意疗效。
Objective To evaluate the outcomes of thoracoseopy-assisted mini-incision procedure in patients with lung cancer. Methods From January 2003 to June 2003, 66 patients with non-small cell lung cancer were treated in our hospital by lobectomy combined with mediastinal lymph node resection using thoraeoscopy-assisted mini-incision (36 patients, VATS Group) or traditional surgery ( 30 patients, traditional group). The clinical and follow-up data of the two groups were compared after the operation. Results No significant difference was found in the operation time between the VATS and traditional groups[ (114.6± 47.4) rain vs (123.3 ± 43.9 ) rain, t = -0. 768, P = 0. 449 ] , while the postoperative hospital stay of the VATS group was significantly shorter than that in the traditional group [(9.2±1.4) d vs (10.5 ±1.7) d, t = -3.408, P=0.0011. Log-rank test showed that the survival curve in the two groups was comparable (X^2 = 0. 270, P = 0. 605 ). Cox regression model indicated that the pathological characteristics ( risk ratio : 3.912, P = 0. 000) , TN M stage ( risk ratio : 3. 737, P = 0. 000), and lymph node metastasis ( risk ratio : 15. 495, P =0. 000) were independent, unfavorable prognostic factors for the disease; whereas, no relation was detected between the thoracotomy incision and prognosis (P = 0. 414). Conclusions Thoraeoseopy-assisted mini-incision procedure is a safe and reliable approach for patients with lung cancer with satisfying outcomes.
出处
《中国微创外科杂志》
CSCD
2009年第1期33-35,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
电视胸腔镜
肺癌
肺叶切除术
Video-assisted thoracoscopic surgery
Lung cancer
Lobectomy