完全电视胸腔镜与电视胸腔镜辅助小切口行肺癌根治术的临床研究

Comparison of complete video-assisted thoracoscopic surgery and thoracoscopy-assisted mini-incision in treatment for lung cancer

目的探讨完全电视胸腔镜行肺癌根治术的临床价值。方法选取2009年3月至2012年8月收治的287例非小细胞肺癌患者,其中209例在完全电视胸腔镜下行肺癌根治术(VATS组),78例电视胸腔镜辅助小切口行肺癌根治术(VAMT组),比较分析两组围手术期相关临床指标的变化。结果两组均无严重并发症和围手术期死亡。VATS组与VAMT组比较,在手术时间、淋巴结清扫个数、术中出血量和术后胸腔置管时间等方面差异无统计学意义(P>0.05)。术后住院时间、术后1天血清C反应蛋白(CRP)中CRP含量等方面差异有统计学意义(P<0.05);VATS组平均住院天数(9.0±2.1天)较VAMT组(13.1±2.4天)短;VATS组术后1天CRP值(43.1±11.7 mg/L)较VAMT组(62.6±15.1 mg/L)优。结论完全电视胸腔镜肺叶切除可彻底清扫淋巴结,急性期反应程度轻、恢复较快、住院时间短,是非小细胞肺癌的良好手术途径。

Objective To investigate the clinical value of complete video- assisted thoracoscopic resection of lung cancer. Method 287 cases of non-small cell lung cancer patients treated in our hospital between March 2009-August 2012 were enrolled, in which 209 cases received complete video-assisted thoracoscopic lung resection line（VATS group）, and 78 cases underwent thoracoscopy-assisted mini-incision with lung resection line（VAMT group）,of the two group, the related perioperative clinical indices were compared and variations were analyzed. Result There were no serious complications and perioperative mortality within both groups. In aspects of operative time,number of lymph node dissection, intraoperative blood loss and the retention time of postoperative chestcatheterization, the differences between VATS and VAMT groups were not statistically significant（P〉0.05）. While the postoperative hospitalization days, and postoperative CRP levels in CRP serum on day 1 were statistically different（P〈0.05）. VATS group showed shorter average hospitalization days（9.0±2.1 d） than that of VAMT group（13.1±2.4 d）,with lower postoperative CRP value of day 1 than that in VAMT group（43.1±11.7 mg/L vs 62.6±15.1 mg/L）. Conclusion Completely lymph node dissection is achievable in VATS lobectomy, with mild acute phase reaction, faster recovery, shorter hospital stay, which is a good surgical approach for non-small cell lung cancer.