胸腔镜下早期肺癌根治术的临床疗效探讨

Discussion of curative effects on thoracoscopic radical resection of early stage lung cancer

目的探讨胸腔镜下行肺叶切除淋巴结扩清术在肺癌治疗中的安全性、有效性及适应证。方法 2009年8月至2012年8月行全胸腔镜下肺癌根治术83例,其中男性47例,女性36例,平均年龄55.5岁。手术均通过3个胸腔镜操作孔完成,肺叶切除及淋巴结清扫的操作方法和顺序与常规开胸手术大致类似。结果本组83例手术均顺利完成,手术时间70～380min,术中出血80～900mL,术后胸管引流2～14d。术中术后未发生严重并发症及死亡病例,中转开胸3例。术后病理结果:腺癌53例,鳞癌28例,肉瘤样癌2例。术后随访平均6.7个月,3例腺癌病人术后3～9个月发生肝转移、脑转移,其余无复发。结论全胸腔镜下肺癌根治术是可行的,在有效性、彻底性、安全性方面可达到传统开胸手术同样的根治效果,是早期非小细胞肺癌的一种安全、有效、可行的手术治疗方法。

Objective To investigate the safety, efficacy and operation indication of the thoracoscopic radical resection for early stage lung cancer. Methods From August 2009 to August 2012,83 patients with early stage lung cancer underwent thoracoscopic radical resection. .There were 47 male and 36 female, an average age of 55.5 years old. The surgical procedure and approach were similar to conventional open lobectomy. Results All operations were carried out safely. Operative time was 70-380 min, intraoperative blood loss was 80-900 mL. There were no operative death or serious operative complications. There were 3 patients transferred to open thoracotomy. Postoperative pathological results included adenocarcinoma in 53 patients ,.squamous carcinoma in 28 patients and sarcomatoid carcinoma in 2 patients..The average postoperative follow-up time was 6.7 months ,.and three cases with lung adenocarcinoma were found liver and brain metastases on 3-9 months after operation. Conclusion Thoracoscopic radical resection of lung cancer is a safe and feasible surgical procedure compared with conventional open thoracic surgery. .It is a safe,.effective and feasible method for treatment of non-small cell lung cancer.