胸腔镜肺段切除术与开放性肺段切除术的临床比较研究

Clinical assessment of patients with VATS anatomical segmentectomy and open anatomical segmentectomy

目的:对胸腔镜肺段切除术与开放式肺段切除术治疗非小细胞肺癌及其他孤立性肺结节的临床资料进行比较。方法:回顾性分析2009年1月—2012年6月接受胸腔镜解剖性肺段或多肺段联合切除术的10例患者以及接受开放式肺段切除术的7例患者的临床资料。比较两组患者的肿瘤最大径、清扫淋巴结组数、清扫淋巴结个数、手术时间、术中出血量、术后住院时间和术后并发症。结果:胸腔镜肺段切除术相较于开放性肺段切除术,可缩短术后住院时间(4.4±1.1vs6.6±1.0d,P<0.05);两组的手术时间、术中出血量、肿瘤最大径、清扫淋巴结组数和清扫淋巴结个数的差异均无统计学意义;两组患者均未出现术后并发症。结论:胸腔镜解剖性肺段切除术是一种安全的手术方式,值得在临床上进一步推广。

Objective： To compare the clinical information between the patients receiving VATS （video- assisted thoracoscopic surgery） anatomic segmentectomy and open anatomic segmentectomy in the treatment of early stage non-small cell lung cancer and solitary pulmonary nodules. Methods： The clinical records of 10 patients receiving VATS anatomical segmentectomy and 7 patients receiving open anatomic segmentectomy between January 2009 and June 2012 were retrospectively analyzed. The maximum diameter of the lung lesion, number of lymph node groups dissected, number of lymph nodes dissected, duration of operation, intraoperative blood loss, length of hospital stay after surgery and post-operative complications between the two operation groups were compared. Results： The length of hospital stay after surgery was significantly shortened in VATS anatomical segmentectomy group as compared with that in the open anatomic segmentectomy group （4.4＋1.1 vs 6.6_＋1.0 d, P 〈 0.05）. There were no significant differences in the duration of operation, intraoperative blood loss, maximum diameter of the lung lesion, number of lymph node groups dissected, and the number of lymph nodes dissected between the two groups. No postoperative complications were observed in the two groups. Conclusion： VATS anatomic segmentectomy can be safely conducted in patients with early stage NSCLC or solitary pulmonary nodules, and this operative approach should be recommended in clinical practice.