VATS解剖性肺段切除术与肺叶切除术治疗Ⅰ_a期NSCLC患者的手术情况及对肺功能影响的比较

The comparison of surgical situation and the effect of pulmonary function between VATS anatomic segmental resection and lobectomy on NSCLC patients in stage I_a

目的:探讨电视胸腔镜(VATS)解剖性肺段切除术与肺叶切除术治疗I_a期非小细胞肺癌(NSCLC)患者的手术情况及对患者肺功能的影响。方法:选取我院手术治疗的Ⅰ_a期NSCLC患者,收集时间2014年1月至2016年12月,根据术式不同分为两组,均采用VATS手术治疗,A组(54例)患者采用解剖性肺段切除术、B组(60例)采用肺叶切除术治疗,对比两组患者的手术效果及术后肺功能变化。结果:A组患者的手术时间、清扫淋巴结数目与B组比较差异无统计学意义(P>0.05);A组患者的手术出血量、术后胸腔引流量、术后拔管时间、术后住院时间均显著的低于B组患者(P<0.05);术前,A组和B组患者的FEV1%、FVC%、MVV%测定值差异无统计学意义(P>0.05),术后3个月复查,A组患者的FEV1%、FVC%、 MVV%测定值均显著高于B组患者(P<0.05);手术后,A组患者的并发症发生率(7.41%)低于B组患者(13.33%),但是差异无统计学意义(P>0.05)。结论:VATS解剖性肺段切除术治疗Ⅰ_a期NSCLC患者具有手术创伤小、术后恢复快、对患者肺功能影响更小的优势。

Objective:To investigate the surgical situation and the effect of pulmonary function between video-assisted thoracoscopy(VATS) anatomic segmental resection and lobectomy for the treatment of non-small cell lung cancer(NSCLC) patients in stage Ia.Methods:The patients with stage Ⅰa NSCLC treated in our hospital from January 2014 to December 2016 were collected.Two groups of patients were treated with VATS surgery.A group(54 cases) was treated with anatomic segmentectomy,B group(60 patients) with lobectomy.Pulmonary function changes and the effect of the operation of the two groups were compared.Results:The operation time and number of lymph node between A and B group had no significant difference(P>0.05),and surgery hemorrhage,thoracic drainage volume,postoperative extubation time,postoperative hospitalization time in A group were significantly lower than B group(P<0.05).Before operation,FEV1%,FVC%,MVV% had no statistically significant difference between the two groups(P>0.05).3 months after surgery,FEV1%,FVC%,MVV% in A group was significantly higher than in B group(P<0.05).After the surgery,the complication rate in the A group was 7.41%,which was lower than that of B group(13.33%).But there was no statistically significant difference(P>0.05).Conclusion:VATS dissection for NSCLC patients with stage Ia has the advantages of small surgical trauma,rapid postoperative recovery and less impact on the pulmonary function of the patients.