比较单孔胸腔镜肺段切除术与肺叶切除术治疗高龄早期非小细胞肺癌患者的效果

Clinical comparative study of two kinds of single-hole thoracoscopy in the treatment of elderly patients with NSCLC

目的比较单孔胸腔镜(VATS)肺段切除术与肺叶切除术治疗高龄早期非小细胞肺癌(NSCLC)患者的效果。方法回顾性分析2017-03—2020-04间新乡市中心医院胸瘤二科行单孔VATS治疗的182例高龄早期NSCLC患者的临床资料。依据术式分为肺叶切除术组(100例)和肺段切除术组(82例)。比较2组患者的基线资料、术中情况、术后临床指标,以及术后病理学检查结果。结果 2组患者的基线资料、手术时间、术中出血量,淋巴结清扫总站数和清扫总个数、病理TNM分期,以及术后视觉模拟(VAS)评分、引流时间和引流量、肺部感染发生率、住院时间、总治疗费用等指标比较,差异均无统计学意义(P>0.05)。肺叶切除术组的房颤和DVT发生率均显著少于肺段切除术组,肿瘤最大直径和鳞癌比例均显著多于肺段切除术组,差异均有统计学意义(P<0.05)。结论单孔VATS肺段及肺叶切除术治疗高龄早期NSCLC近期效果相同,可根据患者的具体病情个体化予以选择。

Objective To compare the effect of single-hole thoracoscopy(VATS)lobectomy and lobectomy in the treatment of advanced non-small cell lung cancer(NSCLC)patients.Methods The clinical data of 182 elderly patients with early NSCLC treated with single-hole VATS were retrospectively analyzed.It was divided into lobectomy group(100 cases)and segmental resection group(82 cases).Comparison of baseline data,intraoperative data and postoperative clinical indicators of 2 groups,And postoperative pathology.Results There was no significant difference in baseline data,operative time,intraoperative blood loss,postoperative visual analogue(VAS)score,drainage time and drainage volume,incidence of pulmonary infection,hospitalization time,total treatment cost,pathological TNM stage(P>0.05).The total number of lymph node dissection in lobectomy group was significantly higher than that of lung segment group,the incidence of atrial fibrillation and DVT was significantly lower than that of lung segment group,and the maximum diameter of tumor and the proportion of squamous cell carcinoma were significantly higher than that of lung segment group(P<0.05).Conclusion Single hole VATS lobectomy and lobectomy have similar short-term effect in the treatment of early NSCLC of old age,and can be selected according to the specific condition of the patient.