全胸腔镜下肺癌根治术与开胸肺癌根治术围手术期结果及淋巴结清扫的比较

Comparison of perioperative outcomes and lymphadenectomy after thoracoscopic lobectomy and open lobectomy

目的:比较全胸腔镜下肺癌根治术与开胸肺癌根治术的围手术期结果及淋巴结清扫情况。方法:选取赤峰市第二医院2013年5月至2015年7月行全胸腔镜下肺癌根治术患者62例,2012年4月至2013年5月行开胸肺癌根治术62例,观察两组患者手术时间、术中出血、术后并发症和淋巴结清扫情况。结果:胸腔镜组手术时间(120.6±24.1)min,短于开胸组的(146.3±21.2)min,术中出血量为(210.82±132.62)ml,少于开胸组(252.83±176.45)ml;两组手术时间及手术出血量差异有显著性(P<0.01)。胸腔镜组和开胸手术组术后无大出血及再次手术止血的患者,未出现支气管胸膜瘘及脓胸,开胸组术后一例死于肺栓塞。胸腔镜组和开胸手术组的平均淋巴结清扫个数分别为(12.19±6.10)枚和(11.35±7.10)枚,两组差异无显著性(P>0.01)。结论:胸腔镜下肺癌根治术创伤小,缩短手术时间,减少并发症,在淋巴结清扫上可以达到与开胸手术一样的效果。

ObjectiveCompared the perioperative outcomes and lymphadenectomy after thoracoscopic lobectomy and open lobectomy. Methods ： Sixty - two consecutive patients who underwent VATS lobectomy between May 2013 and July 2015,were compared with 62 patients who underwent open lobectomy between April 2012 and May 2013, outcomes included surgical time,blood loss, incidence of complications and gained lymph nodes. Results： The time of operation of the thoracoscopic group was（ 120. 6 ±24. 1） min, and （146. 3 ±21.2） min in the open lobectomy, the blood coss were （210. 82 ± 132. 62） ml in the thoracoscopic goup, white results in open lobectomy were （252. 83 ± 176.45） ml,there were significant difference btween the two groups in length of operation and blood coss（ P 〈 0. 01 ）. Thoracoscopy and thoracotomy group postoperative bleeding and no re - operation to stop bleeding in patients with bronchial fistula and empyema, thoracotomy group after one died of pulmonary embolism occurred. the mo- mbers of obtained lymph nodes in the thoracoscopic group and open Lobectomy group were （12. 19 ±6. 40） and （11.35 ±7. 10）,there were no significant differences between the two groups（ P 〉0. 01）. Conclusion：The thoraco-scopic lobecotmy for lung cancer can minimus trauma, reduce post - operative complications. Shorten the operation time,and effective perform lumph node dissection.