Ⅰ期非小细胞肺癌两种切除术式效果比较

Curative effect of thoracoscopic sublobar resection in patients with stage Ⅰ non-small cell lung cancer compared with lobectomy

目的比较胸腔镜亚肺叶切除术与肺叶切除术治疗Ⅰ期非小细胞肺癌的效果。方法入选Ⅰ期非小细胞肺癌患者210例,随机分为肺叶切除术组和亚肺叶切除术组,每组105例。随访至术后18个月。比较两组的患者特征、肿瘤特点、手术相关指标及预后。结果两组之间,患者年龄、性别、肺癌病理分型、分期、直径和部位均无统计学差异。亚肺叶切除术组住院时间明显短于肺叶切除术组,且出血量也明显少于肺叶切除术组(P<0.05)。两组之间,全因死亡率、肺癌死亡率、复发率、局部复发率、远处复发率、心脏并发症等方面比较,均没有统计学差异。亚肺叶切除术组肺部并发症发生率明显低于肺叶切除术组(P<0.05)。结论相对于肺叶切除术,亚肺叶切除术缩短了住院时间,减少了术中出血,减少了肺部并发症。

Objective To compare the curative effect of thoracoscopic sublobar resection in patients with stage I non-small cell lung cancer with that of lobectomy. Methods 210 patients with stage I non-small cell lung cancer were enrolled,divided into the lobectomy group（105 patients） and sublobar resection group（105 patients）, and followed up for 18 months after operation.Results There was no difference in age,sex,pathological type,stage,diameter or area of tumors between these two groups（P〉0. 05）. The sublobar resection group had shorter hospital stay,smaller blood loss volumes and fewer pulmonary complications（P〈0. 05） than the lobectomy group. There was no difference in the rate of total recurrence,local recurrence and distant recurrence,cardiac complications,all-cause death or death caused by lung cancer between the two groups. The incidence of pulmonary complications of the sublobar resection group was significantly lower than that of the lobectomy group（P〈0. 05）. Conclusions Compared with thoracoscopic lobectomy,sublobar resection can shorten hospital stay,lower the blood loss volume and reduce pulmonary complications.