胸腔镜肺癌根治术36例治疗体会

Treatment Experience of 36 Cases with Thoracoscopic Radical Resection of Lung Cancer

目的对胸腔镜肺癌根治术的近远期疗效进行临床评价,探讨胸腔镜肺癌根治术的可行性和安全性。方法抽选2016年2月—2017年4月该收治的36例患者开展胸腔镜肺叶切除+系统淋巴结清扫治疗(胸腔镜组),同期选择36例肺癌患者开展传统开胸肺癌根治术治疗(开胸组),观察两组围手术期临床指标,随访3-12个月观察复发转移情况,采用癌症患者生活质量评估量表(QLQ-52)评价两组患者生活质量改善情况。结果两组患者除手术时间外,胸腔镜组术中出血量(95.28±27.80)m L、术后胸腔引流量(214.94±55.67)m L、首次下床活动时间(2.10±1.30)d、术后住院时间(8.90±2.33)d各项临床指标均优于开胸组(t=0.482、11.492、9.204、12.553、10.636,P<0.05);随访发现在复发转移方面,胸腔镜组(8.33%)与开胸组(11.11%)比较差异无统计学意义(χ2=0.199,P<0.05);胸腔镜组术后6个月QLQ-52得分(56.29±14.50)分明显低于开胸组(85.83±16.32)分,生活质量较术前获得显著提升,与开胸组比较,差异有统计学意义(t=11.580,P<0.05)。结论胸腔镜肺癌根治术的近远期疗效都比较确切,能够显著提升患者生活质量,值得推广与深入研究。

Objective To conduct the clinical evaluation of short-term and long-term curative effect of thoracoscopic radical resection of lung cancer and study its feasibility and safety. Methods 36 cases of patients admitted and treated in our hospital from February 2016 to April 2017 were treated with thoracoscopic lobectomy plus systematic lymph node dissection（thoracoscopic group）, while 36 cases of patients with lung cancer were treated with traditional thoracic radical resection of pulmonary carcinoma, and the clinical indexes during the perioperative period of the two groups were observed, and the recurrence and metastasis was observed after 3-12 months follow-up, and the improvement situation of quality of life of the two groups was evaluated by the QLQ-52 scale. Results The intraoperative bleeding amount, postoperative pleural drainage volume, first time to get out of bed and postoperative length of stay in the thoracoscopic group were respectively（95.28±27.80）m L,（214.94±55.67 m L）,（2.10±1.30）d,（8.90±2.33）d, which were better than those in the thoracic group（t =0.482、11.492、9.204、12.553、10.636, P〈0.05）,and the difference in the recurrence and metastasis between the two groups was not obvious, without statistical significance（8.33% vs 11.11%）,（χ^2=0.199,P〈0.05）, and the QLQ-52 scores in 6 months after surgery were obviously lower than those in the thoracic group [（56.29±14.50）points vs（85.83±16.32）points], and the quality of life was obviously improved compared with that before surgery,and the difference between the two groups was obvious（t=11.580,P〈0.05）. Conclusion The short-term and long-term curative effect of thoracoscopic radical resection of lung cancer is definite, which can obviously improve the quality of life, and it is worth promotion and deep research.