全胸腔镜下肺叶切除术与常规开胸肺叶切除术治疗肺癌的效果比较

Comparison of the effect of total thoracoscopic lobectomy versus conventional thoracotomy in treatment of lung cancer

目的:比较肺癌患者采用全胸腔镜下肺叶切除术和常规开胸肺叶切除术治疗的临床效果。方法:抽取2015年1月至2016年11月滨州医学院附属医院收治的82例的肺癌患者的临床资料,根据手术方式不同将其分为对照组和观察组,每组41例。对照组患者行常规开胸肺叶切除术,观察组患者行全胸腔镜下肺叶切除术。比较两组患者手术相关指标、术后免疫功能指标、远期生存情况(局部复发、远处转移、1年生存、3年生存)。结果:观察组手术时间、置管引流时间、下床活动时间、疼痛持续时间均短于对照组,术后引流量少于对照组,淋巴清扫量多于对照组,术后视觉模拟评分法(VAS)评分低于对照组,差异均有统计学意义(P均<0.05);术后3、6个月,两组CD4+、CD8+、CD4+/CD8+指标均下降,且观察组均高于对照组,差异均有统计学意义(P均<0.05);观察组局部复发率、远处转移率略低于对照组,1年生存率及3年生存率略高于对照组,但差异未见统计学意义(P>0.05)。结论:肺癌患者给予全胸腔镜下肺叶切除术能够促进患者术后恢复,提高术后免疫功能,与常规手术相比,可在一定程度上降低复发率,提高远期生存率。

Objective To compare the effect of total thoracoscopic lobectomy and conventional thoracotomy lobectomy in treatment of lung cancer.Methods The clinical data of 82 patients with lung cancer admitted to Binzhou Medical College Affiliated Hospital from January 2015 to November 2016 were retrospectively collected.According to different surgical methods,the patients were divided into control group and observation group,with 41 patients in each group.Patients in the control group received conventional thoracotomy lobectomy,and patients in the observation group received total thoracoscopic lobectomy.The indexes related to surgery,postoperative immune function and long-term survival(local recurrence,distant metastasis,1-year survival and 3-year survival)were compared between the two groups.Results The operative time,catheter drainage time,normal activity time and duration of pain in the observation group were all shorter than that in the control group.The postoperative drainage volume was less than that in the control group,the amount of lymph node dissection was more than that in the control group,and the postoperative VAS score was lower than that in the control group,with statistically significant differences(all P<0.05).Three and six months after operation,CD4+,CD8+,CD4+/CD8+indexes in both groups decreased,and those in the observation group were higher than those in the control group,with statistically significant differences(all P<0.05).The local recurrence rate and distant metastasis rate in the observation group were slightly lower than those in the control group,and the 1-year and 3-year survival rates were slightly higher than those in the control group,but the differences were not statistically significant(P>0.05).Conclusions Total thoracoscopic lobectomy for patients with lung cancer can promote postoperative recovery and improve postoperative immune function.Compared with conventional surgery,it can reduce recurrence rate to a certain extent and improve long-term survival rate.