胸腔镜肺段切除术在早期肺癌中的应用效果

Application effect of thoracoscopic segmental pneumonectomy in early lung cancer

目的探讨电视胸腔镜外科手术(VATS)肺段切除术在早期肺癌中的应用效果。方法选择2019年11月至2021年10月华南理工大学附属第六医院的60例早期非小细胞肺癌(NSCLC)患者作为研究对象,采用随机数字表法将其分为肺叶组(30例)与肺段组(30例)。肺叶组采用VATS肺叶切除术治疗,肺段组采用VATS肺段切除术治疗。比较两组围手术期指标、肺功能及并发症。结果两组的术中出血量、手术时间、淋巴结清扫数目比较,差异无统计学意义(P>0.05)。肺段组的住院时间短于肺叶组,术后肺段组的第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)高于肺叶组,肺段组的并发症总发生率低于肺叶组,差异有统计学意义(P<0.05)。结论VATS肺段切除术治疗早期NSCLC的临床效果与肺叶切除术相当,但VATS肺段切除术并发症少且对患者肺功能的影响小,患者术后恢复快,可作为治疗早期NSCLC的一种较为安全、有效术式。

Objective To investigate the effect of video-assisted thoracic surgery(VATS)segmentectomy in early lung cancer.Methods A total of 60 patients with early non-small cell lung cancer(NSCLC)in the Sixth Affiliated Hospital of South China University of Technology from November 2019 to October 2021 were selected as the research objects.They were divided into lung lobe group(30 cases)and lung segment group(30 cases)according to the random number table method.The lobar group was treated with VATS lobectomy,and the segmental group was treated with VATS segmentectomy.The perioperative indexes,pulmonary function and complications were compared between the two groups.Results There were no significant differences in intraoperative bleeding,operation time and the number of lymph node dissection between the two groups(P>0.05).The length of hospital stay in the lung segment group was shorter than that in the lung lobe group,the forced expiratory volume in one second(FEV_(1))and forced vital capacity(FVC)in the lung segment group were higher than those in the lung lobe group,and the differences were statistically significant(P<0.05).The total incidence of complications in the lung segment group was lower than that in the lung lobe group,and the difference was statistically significant(P<0.05).Conclusion The clinical effect of VATS segmental pneumonectomy in the treatment of early NSCLC is equivalent to that of lobectomy,but VATS segmental pneumonectomy has less complications,less impact on patients′lung function and rapid postoperative recovery.It can be used as a safe and effective method for the treatment of early NSCLC.