全胸腔镜支气管袖式肺叶切除术治疗中央型肺癌的疗效

Efficacy of complete video-assisted thoracic surgery of bronchus sleeve lobectomy in treating central type lung cancer

目的探讨全胸腔镜支气管袖式肺叶切除术治疗中央型肺癌的疗效及安全性。方法中央型非小细胞肺癌患者30例,9例采用全胸腔镜支气管袖式肺叶切除术(微创组),21例行开胸支气管袖式肺叶切除术(开胸组)。比较两组手术相关资料、术后疼痛评分及并发症发生情况。结果两组肿瘤直径、淋巴结总数、淋巴结组数、病理类型、病理分期、肺切除类型、手术时间、术中出血量及胸腔引流量比较差异均无统计学意义(P>0.05)。与开胸组比较,微创组术后1d及3d疼痛评分较低(P<0.05)。微创组患者胸腔引流置管时间和术后住院时间均短于开胸组(P<0.05)。术后并发症:开胸组8例,微创组2例。结论全胸腔镜支气管袖式肺叶切除术治疗中央型肺癌安全、可行,较开胸手术患者术后疼痛轻、住院时间短。

Objective To explore the efficacy and safety of complete video-assisted thoracic surgery（VATS）of bronchus sleeve lobectomy in the treatment of central type lung cancer.Methods The bronchus sleeve lobectomy was performed in 30 patients with central type lung cancer,of whom 9cases were operated by VATS（group A）and 21 cases by open surgery（group B）.The surgery-related data,postoperative pain score and complications were compared between two groups.Results There were no statistical differences in tumor diameter,total number of lymph nodes and lymph node group,pathological type and stage,operation time,intraoperative blood loss and the amount of thoracic cavity drainage between two groups（P〉0.05）.Compared to group B,the postoperative pain scores on the1 st and 3rd day after operation were lower,the withdrawl of drainage tube was earlier and postoperative hospital stay was shorter in group A（P〈0.05）.The postoperative complications occurred in 2cases of group A and in 8cases of group B.Conclusion Compared with open-surgery,bronchus sleeve lobectomy under VATS is effective and safe.Compared to open surgery,bronchus sleeve lobectomy under VATS has the advantages of less postoperative pain and shorter postoperative hospital stay.