胸腔镜肺叶切除术与肺段切除术对高龄早期非小细胞肺癌的治疗效果比较

Comparison of Thoracoscopic Lobectomy and Segmentectomy in Elderly Patients with Non-small Cell Lung Cancer

目的:比较高龄(≥70岁)IA期非小细胞肺癌患者行腔镜下肺叶切除与肺段切除的治疗效果。方法:根据手术方式,将111例IA期非小细胞肺癌高龄患者分为肺叶切除组(73例)和肺段切除组(38例),分别在胸腔镜下行肺叶或肺段切除术,比较两组患者手术情况及预后情况。结果:肺叶切除组手术时间显著短于肺段切除组,术中出血量、术后3天引流量、术后住院时间则显著多于肺段切除组(P<0.01);两组并发症发生率、复发及转移率差异均无统计学意义(P>0.05);两组术后30天内均未出现死亡病例。结论:肺叶切除与肺段切除具有相似预后,然肺段切除术虽然手术时间较长,但出血量、引流量的减少是其优势,可考虑作为治疗高龄IA期非小细胞肺癌的术式之一。

Objective： To compare the efficacy of thoracoscopic lobectomy and segmentectomy in elderly patients（≥70-year-old） with IA stage of non-small cell lung cancer. Methods： According to the operation choices, 111 cases of elderly patients with IA stage of non-small cell lung cancer were divided into lobectomy group（73 cases） and segmentectomy group（38 cases）, who were carried out lobectomy and segmentectomy under thoracoscope separately, then compared the surgical status and prognosis of the two groups. Results： The operation time of lobectomy group was significantly shorter than that of segmentectomy group, while intraoperative blood loss, drainage quantity at 3 days after operation and hospitalization time were more than those of segmentectomy group（P〈0.01）; there was no statistical difference between incidence of complications, recurrence and metastasis of the two groups（P〉0.05）; there was no deaths occurred within 30 days after operation in both groups. Conclusion： Segmentectomy has similar prognosis to lobectomy, although the operation time of segmentectomy is longer, its decrease of blood loss and drainage quantity makes it possible to be considered as one of the operative methods for elderly patients with IA stage of non-small cell lung cancer.