完全胸腔镜下肺叶与肺段切除术治疗Ⅰ期肺癌的临床对比研究

A comparative study of totally thoracoscopic lobectomy and segmentectomy in the treatment of stage I lung cancer

目的对比研究完全胸腔镜下肺叶与肺段切除术治疗I期肺癌的临床效果。方法根据患者实际手术术式分组,行完全胸腔镜下肺叶切除术患者155例(肺叶切除组)、行完全胸腔镜下肺段切除术患者134例(肺段切除组),比较两组临床效果。结果肺段切除组手术时间长于肺叶切除组(P<0.05),两组术中出血量、手术时间、清扫淋巴结个数及术后引流时间比较,差异均无统计学意义(P>0.05);用力肺活量(FVC)、1秒钟用力呼气量与用力肺活量比值(FEV1%)两组术后均较术前下降(P<0.01),肺段切除组术后FVC与FEV1%均优于肺叶切除组(P<0.01)。结论完全胸腔镜下肺叶与肺段切除术治疗I期肺癌近期效果无明显差异,但肺段切除术对于患者肺功能的保护更为有利。

Objective To compare clinical efficacy of totally thoracoscopic lobectomy and segmentectomy in the treatment of stage I lung cancer. Methods According to actual patient surgery,one hundred and fifty five cases who had undergone completely thoracoscopic lobectomy were selected as lobectomy group while 134 cases who had been given completely thoracoscopic pulmonary resection were chosen as lung resection group. The clinical efficacy of the two groups were compared. Results The operation time of patients in lung resection group was longer than that in the lobe resection group（P〈0. 05）. The differences in bleeding volume during operations,operation time,number of clearing lymph nodes and draining time between the two groups had no statistical significant（P〈0. 05）. Forced vital capacity（ FVC） and one second forced expiratory volume（ FEV1%） in the two groups after operation were decreased compared with those before operations（P〈0. 01）. FVC and FEV1% in lung resection group were better than those in lobectomy group（P〈0. 01）. Conclusion Clinical efficacy of totally thoracoscopic lobectomy and segmentectomy in the treatment of stage I lung cancer has no significant difference,but pulmonary resection can provide better protection to patient＇s lung function.