全胸腔镜肺叶切除治疗早期肺癌48例临床分析

Clinical effect of the thoracoscopic lobectomy in the treatment of early lung cancer in 48 cases

目的：探讨全胸腔镜下肺叶切除的临床体会并评价其临床疗效。方法：回顾性分析行全胸腔镜下肺叶切除48例患者临床资料。结果：48例均采用四孔法完成手术,行系统性淋巴结清扫和解剖性肺叶切除,其中行左上肺叶切除14例,左下肺叶切除6例,右肺上叶切除17例,右肺中叶切除1例,右肺下叶切除10例。无围手术期死亡,中转开胸1例。手术时间90~250 min,术中出血量40~1 000 ml,术后拔管时间3~11 d,清扫淋巴结数目7~24枚。术后住院时间6~14 d。术后病理结果：腺癌35例,鳞癌8例,小细胞肺癌1例,肺泡细胞癌2例,腺鳞癌2例。术后随访6~19个月,无复发转移病例。结论：全胸腔镜肺叶切除治疗早期肺癌具有创伤小、并发症少、术后恢复快等优点,近期疗效满意。

Objective： To explore the clinical effects of the thoracoscopic lobectomy in the treatment of early lung cancer. Methods：The clinical data of 48 patients treated with thoracoscopic lobectomy were retrospectively analyzed. All patients were treated with four hole method operation,systemic lymph node cleaning and anatomical lobectomy. Results： The operations included 14 cases of left upper lobectomy,6 cases of left lower lobectomy,17 cases of right upper lobectomy,1 case of right middle lobectomy and 10 cases of right lower lobectomy. No case died in perioperation,and 1 case was transited to open chest. The operation time,intraoperative blood loss,postoperative extubation time,the number of cleaning lymph node and postoperative hospital stay were 90 to 250 min,40 to 1 000 ml,3to 11 days,7 to 24 and 6 to 14 days,respectively. Adenocarcinoma in 35 cases,squamous carcinoma in 8 cases,small cell lung cancer in1 case,alveolar cell carcinoma in 2 cases and adenosquamous carcinoma in 2 cases were diagnosed by pathology. No recurrence and metastasis case was found during the following up for 6 to 19 months. Conclusions： The thoracoscopic lobectomy in the treatment of early lung cancer is small trauma,less complications,fast recovery and good effects.