肺癌伴肺裂发育不良应用无肺裂肺叶切除法疗效观察

Clinical Outcomes of Fissureless Technique to Practice Lobectomy with Fused Fissure for Lung Cancer

背景与目的肺癌伴肺裂发育不良患者应用传统肺叶切除方法常导致术后发生肺持续漏气。本研究旨在观察无肺裂肺叶切除技术对这类患者的疗效,探讨此技术的临床应用价值。方法回顾性分析2011年8月-2012年12月青岛大学医学院附属医院胸外科274例肺癌伴肺裂发育不良的临床资料。按肺叶切除技术分为无肺裂肺叶切除组(A组)和传统肺叶切除组(B组)。采用SPSS17.0软件处理数据,Kaplan-Meier法计算术后累计肺漏气停止时间,Logistic回归进行多因素分析。结果 A组较B组的肺持续漏气发生率(P=0.009)和术后漏气时间(P<0.001)明显降低;两组术后胸腔引流时间、术后胸腔液体引流量以及术后住院时间差异无明显统计学意义。结论肺癌伴肺叶发育不良应用无肺裂肺叶切除技术,能明显降低术后肺持续漏气发生率及术后肺漏气时间,效果确切。

Background and objective Traditional lobectomy techniques often lead to persistent air leak（PAL） for lung cancer patients companied with fused fissure.The aim of this study is to evaluate the outcomes of those patients undergoing fissureless lobectomy.Methods The clinical data were retro-respectively analyzed from 274 lung cancer patients with fused fissure who received surgical procedures from August 2011 to December 2012.Patients were divided into fissureless group（group A,n=121） and traditional group（group B,n=153） according to the type of lobectomy techniques.The data were analyzed using SPSS 17.0.The air leak cessation was determined using the Kaplan-Meier method.Multiple risk analysis was developed by Logistic regression.Results The incidences of PAL in 2 groups were 1.7% and 9.2%,respectively（P=0.009）.The air leak cessation in group A was significantly lower than that in group B（P＆lt;0.001）.There was no statistical different between 2 groups in the duration of drainage,amount of fluid and length of hospital stay.Conclusion The fissureless lobectomy to fused fissure decreases the incidence of persistent air leak and duration of air leak.This technique should be considered effective to fused fissure lobectomy.