完全胸腔镜下解剖性肺段切除术与肺叶切除术治疗肺部小结节的近期疗效比较

The clinical treatment comparison on completely anatomic thoracoscopic segmentectomy and lobectomy for small pulmonary nodes

目的比较完全胸腔镜下解剖性肺段切除术与肺叶切除术两种手术方式的近期疗效。方法 2011年11月回顾性选取完全胸腔镜下的肺部手术治疗肺部小结节89例,其中肺段切除26例,肺叶切除术63例。比较两组手术时间、术中出血量、清扫淋巴结数目、所用腔镜直线切割缝合器钉仓数目、术后引流量及引流时间、住院时间、住院费用、术后并发症及死亡率。结果两组比较,肺段切除术组相比于肺叶切除术组,术中出血量少、术后引流天数少、术后引流量少、术后平均住院时间短、术中使用钉仓数多(P均<0.05);两组手术时间、清扫淋巴结数目、住院费用无统计学差异(P>0.05);两组患者术后均未出现并发症、复发及死亡。结论胸腔镜肺段切除术与肺叶切除术一样安全有效,但术后恢复更快。

Objective To compare the safety and efficacy of videio-assisted thoracoscopic surgery （VATS） segmentectomy and VATS lobectomy. Methods From Nov 2010 to Jul 2011,26 patients underwent VATS segnentectomy and 63 underwent VATS lobectomy. Intraoperative blood loss and the numbers of staplers used, the numbers of lymph nodes dissected,postoperative drainage time, hospital stay, costs,local recurrence and survial were compared between two groups. Results The intraoperative blood loss, postoperative drainage amount and time, and hospital stay were fewer in segmentectomy group than those in lobectomy group（P 〈0. 05）. The numbers of staplers used were more in segmentectomy group than those in lobectomy group （P 〉 0. 05 ）. There were no significant differences in the operating time, blood loss, numbers of lymph nodes dissected and costs in two groups. No postoperative complications, death and local recurrence occurred in two groups up to now. Conclusions VATS segmentectomy is as safe and effective as VATS lobectomy. Patients underwent VATS segmentectomy recoverd faster.