胸腔镜下肺叶切除及肺段切除治疗早期非小细胞肺癌的近远期疗效

Observation on short-term and long-term efficacy of thoracoscopic lobectomy and segmentectomy in the treatment of early stage non-small cell lung cancer

目的探讨胸腔镜下肺叶切除及肺段切除治疗早期非小细胞肺癌的近远期疗效。方法在我院选取2017年1月—2019年1月收治的92例早期非小细胞肺癌患者为本次研究对象。根据随机抛硬币法分为观察组与对照组,每组各46例患者。对照组采用胸腔镜下肺叶切除,观察组采用胸腔镜下肺段切除。对比两组患者淋巴清除情况、手术相关指标、术后并发症情况及两组患者术后1年生活质量评分。结果观察组系统性淋巴结清扫个数、纵隔淋巴结清扫站数、纵隔淋巴结清扫个数与对照组相似,差异无统计学意义(P>0.05);观察组手术时间长于对照组,但差异无统计学意义(P<0.05);观察组术中出血量、术后总引流量、术后住院时间、胸腔引流时间均低于对照组(P<0.05);观察组并发症总发生率6.52%低于对照组17.39%,但两组数据比较不具有统计学意义(P>0.05);术前两组患者生活质量测定量表(QLQ-C30)评分比较无统计学意义(P>0.05),术后1个月及1年观察组QLQ-C30评分明显高于对照组(P<0.05)。结论胸腔镜下肺段切除较肺叶切除治疗早期非小细胞肺癌可保留更多肺组织,恢复快,创伤较小,远期疗效更佳。

Objective:To explore the short-term and long-term efficacy of thoracoscopic lobectomy and segmentectomy in the treatment of early stage non-small cell lung cancer.Methods:A total of 92 patients with early stage non-small cell lung cancer admitted to the hospital between January 2017 and January 2019 were selected as the subjects of this study.The patients were divided into observation group and control group,with 46 cases in each group,by the random coin tossing method.The control group underwent thoracoscopic lobectomy,while the observation group underwent segmentectomy.The lymphatic clearance,surgery-related indicators,postoperative complications,and quality of life score before surgery and at 1 year after surgery were compared between the two groups.Results:The number of lymph node dissections,the number of mediastinal lymph node dissection stations and the number of mediastinal lymph node dissections in observation group were similar to those in the control group(P>0.05).The surgical time of observation group was longer than that of control group,and the intraoperative blood loss,total postoperative drainage volume,postoperative hospital stay and thoracic drainage time were all less or shorter than those of control group(P<0.05).The total incidence rates of observation group was lower than that of control group(6.52%vs 17.39%),but the difference between the two groups was not statistically significant(P>0.05).There was no statistically significant difference in the Quality of Life Questionnaire-Core 30(QLQC30)score between the two groups before surgery(P>0.05),and the QLQ-C30 score of observation group at 1 month and 1 year after surgery was significantly higher than that of control group(P<0.05).Conclusion:Compared with lobectomy for early stage non-small cell lung cancer,thoracoscopic segmentectomy can preserve more lung tissues,and it has faster recovery,less trauma and better long-term efficacy.