胸腔镜切除单站N2-Ⅲa期非小细胞肺癌的临床价值

Clinical value of thoracoscopic resection of single-station N2-Ⅲa non-small cell lung cancer

目的探讨胸腔镜切除单站N2-Ⅲa期非小细胞肺癌(NSCLC)的临床价值。方法选择2017年7月至2020年8月赣州市肿瘤医院收治的50例NSCLC患者作为研究对象,采用随机数字表法将其分为胸腔镜组(25例)与开胸组(25例)。胸腔镜组采用胸腔镜肺叶切除+系统性纵膈淋巴结清扫术治疗,开胸组采用开胸肺叶切除+系统性纵膈淋巴结清扫术。比较两组的临床指标、疼痛程度及并发症发生情况。结果胸腔镜组的术后住院时间短于开胸组,差异有统计学意义(P<0.05);胸腔镜组的术后第1、3、5天时视觉模拟评分法评分低于开胸组,差异有统计学意义(P<0.05);胸腔镜组的并发症总发生率低于开胸组,差异有统计学意义(P<0.05);两组的术中出血量、手术时间、引流管留置时间、引流量及淋巴结清扫数目比较,差异无统计学意义(P>0.05)。结论胸腔镜手术治疗单站N2-Ⅲa期NSCLC具有损伤小、疼痛轻及并发症少等优点,有利于加快患者术后恢复,用于单站N2-Ⅲa期NSCLC患者的治疗安全可靠。

Objective To explore the clinical value of thoracoscopic resection of single-station N2-Ⅲa non-small cell lung cancer(NSCLC).Methods A total of 50 NSCLC patients admitted to Ganzhou Cancer Hospital from July 2017 to August 2020 were selected as the research subjects.According to a random number table,they were divided into a thoracoscopy group(n=25)and a thoracotomy group(n=25).Patients in the thoracoscopy group were treated with thoracoscopic lobectomy+systematic mediastinal lymph node dissection,and in the thoracotomy group,they were treated with thoracotomy lobectomy+systematic mediastinal lymph node dissection.The clinical indicators,pain degree and complications of the two groups were compared.Results The postoperative hospital stay of the thoracoscopy group was shorter than that of the thoracotomy group with statistical significance(P<0.05).The visual analogue scale score of the thoracoscopy group was lower than those of the thoracotomy group on the 1st day,3rd day,and 5th day after surgery.The total incidence of complications in the thoracoscopy group was lower than that in the thoracotomy group with statistical significance(P<0.05).There were no statistically significant differences in the intraoperative blood loss,operation time,time of indwelling drainage tube,and the amount of drainage and the number of lymph node dissections in the two groups(P>0.05).Conclusion Thoracic surgery for single-station N2-Ⅲa NSCLC has the advantages of less damage,milder pain and fewer complications.It is beneficial to speed up the postoperative recovery of patients,and is safe and reliable for the treatment of patients with single-station N2-Ⅲa NSCLC.