电视胸腔镜辅助小切口手术治疗Ⅰa～Ⅱa期非小细胞肺癌58例疗效观察

Clinical analysis of aideo-assisted mini-thoracoscopy for Ⅰa～Ⅱa non-small cell lung cancer

目的探讨电视胸腔镜辅助小切口(VAMT)手术治疗Ⅰa～Ⅱa期非小细胞肺癌的临床应用价值。方法回顾分析海南省人民医院2005年1月至2011年10月应用电视胸腔镜辅助小切口手术治疗58例Ⅰa-～Ⅱa期肺癌患者的临床资料,观察其手术类型、并发症、术后病理分期和生存率。结果 58例Ⅰa～Ⅱa期肺癌患者手术成功,术中无延长切口,无手术期死亡及严重并发症。8例出现术后并发症,包括胸腔积液5例,肺膨胀不全3例。术后病理分期Ⅰa期20例,Ⅰb期22例,Ⅱb期16例,术后3年生存率为91.4%(53/58)。结论 VAMT遵循手术根治早期肺癌的原则,安全可靠,技术可行,微创经济,可以替代传统的开胸肺叶切除术。

Objective To evaluate the clinical value of video-assisted mini-thoracoscopy for Ⅰ a～ Ⅱ a non-small cell lung cancer. Methods The Clinical data of 58 patients with peripheral Ⅰa～Ⅱa non-small cell lung cancer were retrospectively analyzed from 2005 to oct 2011. The operation type, complications, postoperative pathological stage and survival rate were observed. Results Operational procedures in all the cases were performed successfully, with no incision being prolonged, no death and no severe complication during the operation. There were 5 cases with thoracic effusion and 3 cases with atelectasis after operation. There were 20 patients with pathologic stage Ⅰa, 24 patients with stage Ⅰb, 14 patients with stage Ⅱb, and 3-year survival rate was 63.8%（37/58）. Conclusion Video-assisted mini-thoracoscopy was feasible and safe, with more mini-trauma, rapid recovery and aesthetic advantages, and hence may be technically feasible and satisfactory alterative to conventional thoracotomy.