单向式全胸腔镜肺叶切除治疗非小细胞肺癌

Treatment of non-small cell lung cancer by single-direction thoracoscopic lobectomy

目的:探讨单向式全胸腔镜肺叶切除术治疗非小细胞肺癌的临床安全性、有效性。方法:选取2011年1月~2014年12月连续拟实施151例胸腔镜单向式肺叶切除治疗非小细胞肺癌病例,统计其相关临床资料。结果:共完成135例单向式全胸腔镜肺叶切除手术。中转开胸16例(10.5%),手术时间为70~270 min,出血量50~1200 m L,淋巴结清扫右胸(12.1±1.3)个,左胸(11.6±1.2)个,平均拔管时间(6.1±2.3)d,平均住院时间(7.2±3.5)d。总并发症发生率为27.8%,围手术期无死亡病例。B组手术时间、出血量和中转开胸率均低于A组,且差异有统计学意义(P<0.01);B组手术淋巴结清扫数目略多于A组,且差异有统计学意义(P<0.01);两组术后并发症比较差异无统计学意义(P>0.05)。结论:单向式胸腔镜肺叶切除术规范性、可操作性较好,是安全、有效的治疗非小细胞肺癌的方法。

Objective： To investigate the safety and effectiveness of the single-direction video-assisted thoracic surgery（ VATS） in treatment of non-small cell lung cancer.Methods： The data were retrospectively examined in 151 consecutive patients with non-small cell lung cancer treated with VATS in our department between January 2011 and December 2014.Results： Single-direction thoracoscopic lobectomy was successful in 135 patients,and another 16 required conversion to thoracotomy（ 10.5%）.The operative time ranged from 70 to 270 min,and the intra-operative blood loss ranged from 50 to 1200 m L.Clearance of the lymph nodes was（ 12.1±1.3） via right thorax and（ 11.6±1.2） via left thorax.Mean extubation time was 6 days,and mean hospital stay was（ 7.2±3.5） days.Total complication rate was 27.8%,yet no perioperative death occurred.Group B had shorter operative time,lower blood loss and conversion to thoracotomy,yet had higher number of lymph nodes cleared than group A（ P〈0.01）.The difference was not significant regarding complications between groups（ P〉0.05）.Conclusion： Single-direction thoracoscopic lobectomy may be safe and effective approach to treatment of non-small cell lung cancer.