全胸腔镜肺叶切除及纵隔淋巴结清扫术治疗高龄非小细胞肺癌的临床疗效分析

Analysis of the Clinical Efficacy of Thoracoscopic Lobectomy and Mediastinal Lymph Node Dissection in the Treatment of Senile Non-small Cell Lung Cancer

目的:探讨全胸腔镜肺叶切除及纵隔淋巴结清扫术治疗高龄非小细胞肺癌(non-small cell lung cancer,NSCLC)的临床疗效及其安全性。方法:选择2008年3月至2012年3月在我院住院治疗的NSCLC患者共118例,分为高龄组(≥70岁)26例及非高龄组(<70岁)92例,均接受全胸腔镜肺叶切除及纵隔淋巴结清扫术,观察和比较两组患者的手术时间、术中出血量、术后出血量、术后并发症、术后住院时间、淋巴结清扫枚数及转移枚数及预后情况。结果:两组患者的手术时间、术中出血量、术后出血量、术后并发症、术后住院时间均无统计学差异(P均>0.05);高龄组1年生存率为84.62%,2年生存率为69.23%,非高龄组1年生存率为90.22%,2年生存率为79.34%。两组生存曲线比较无统计学差异(Log-rank x2=3.351,P=0.082)。结论:高龄NSCLC患者全胸腔镜肺叶切除及纵隔淋巴结清扫术可获得与非高龄患者一样良好的治疗效果,因此,该术式是治疗高龄NSCLC患者的可行方法。

Objective： To explore the clinical efficacy and safety of thoracoscopic lobectomy and mediastinal lymph node dissec-tion in the treatment of senile non-small cell lung cancer （NSCLC）. Methods： A total of 118 cases of NSCLC admitted in our hospital from March 2008 to March 2012 were collected and divided into the 26 cases in advanced age group （≥ 70 years） and 92 cases in non-advanced age group （〈70 years）. They were all treated with thoracoscopic lobectomy and mediastinal lymph node dissection, the operation time, blood loss, postoperative bleeding, postoperative complications, postoperative hospital stay, number of lymph node dis- section and transferred as well as the prognosis were observed and compared between the two groups. Results： No statistical difference of operative time, blood loss, postoperative bleeding, postoperative complications, postoperative hospitalization time was found be-tween the two groups （P〉0.05）; the 1-and 2-year survival rate in advanced age group were respectively 84.62% and 69.23%, which were respectively 90.22 % and 79.34% in the non-advanced age group. No statistical difference of survival curve was observed be-tween the two groups （Log-rank x^2=3.351, P=0.082）. Conclusion： Thoracoscopic lobectomy and mediastinal lymph node dissection in the advanced and non-advanced age NSCLC patients serves as the same and good therapeutic effects. Therefore, the procedure is a fea- sible method for the treatment of advanced age patients with NSCLC.