全胸腔镜下肺叶切除治疗非小细胞肺癌

Clinical study of completely thoracoscopic lobectomy for the treatment of non-small cell lung cancer

目的探讨全胸腔镜下肺叶切除治疗非小细胞肺癌的临床疗效及适应证。方法 2011年3月-2014年2月选取该院40例行全胸腔镜下肺叶切除和42例开胸手术治疗的非小细胞肺癌患者,比较两组手术时间、术中出血量、引流量、引流管留置时间、术后疼痛时间、淋巴结清扫数目、术后住院时间、下床活动时间及术后并发症等指标。结果胸腔镜组在胸腔引流管置管时间、术后疼痛时间、下床活动时间及术后住院时间上均显著小于开胸组;在手术时间、术中出血量、术后胸腔引流管总引流量及清扫淋巴结数目上比较,差异无显著性。胸腔镜组术后并发症显著低于开胸组。结论全胸腔镜下肺叶切除治疗非小细胞肺癌能达到传统开胸肺叶切除术相同的疗效,具有创伤小、恢复快及围术期并发证少等优点。

【Objective】To investigate the clinical efficacy of the completely thoracoscopic lobectomy for the treatment of non-small cell lung cancer.【Methods】From March 2011 to November 2013, 80 cases of patients with non-small cell lung cancer were enrolled and randomly divided into VATS group and thoracotomy group. All 40 cases in VATS group were successfully implemented full thoracoscopic lobectomy, and 42 cases in thoracotomy group took thoracotomy approach to complete the operation. The operative time, intraoperative blood loss, chest tube drainage, drainage tube indwelling time, postoperative pain time, number of dissected nodes, postoperative hospital stay, ambulation, postoperative complications and other indicators were compared between the two groups.【Results】The chest tube catheterization time, postoperative pain time, ambulation and postoperative hospital stay in VATS group were significantly less than that in thoracotomy group（all P 0.05）. There were no obvious difference between two groups in the operative time, intraoperative blood loss, postoperative chest tube drainage and the total number of dissected nodes（all P 0.05）. The postoperative complications in VATS group were significantly lower than those in thoracotomy group（P 0.05）. 【Conclusion】The VATS approach for non-small cell lung cancer can achieve the same efficacy as traditional thoracotomy lobectomy. And it has fewer traumas, quicker recovery and fewer perioperative complications. It was worthy of further promotion.