微创肺叶切除与肺段切除治疗早期肺恶性肿瘤的疗效比较

Comparison of clinic effects between minimally invasive lobectomy and segmentectomy for early-stage malignant tumor of lung

目的:探讨微创肺叶切除和肺段切除在治疗早期肺癌中的应用价值。方法:选取某院收治的接受胸腔镜肺叶切除或肺段切除治疗的早期肺癌患者153例,根据手术方式的不同将患者分为微创肺叶组(116例)和微创肺段组(37例),分别采用微创肺叶切除术及微创肺段切除术治疗。比较2组患者的一般资料、手术相关指标(术中出血量、手术耗时、术后胸引管引流量、胸引管留置时间、术后疼痛评分)、住院相关指标(住院费用、术后住院时间),术后并发症及生存情况。结果:微创肺段组患者术后胸引管引流量、胸引管留置时间、术后住院时间分别为(700.41±479.30)mL、(5.00±2.47)天、(6.86±2.57)天,少于微创肺叶组的(940.30±639.27)mL、(6.21±2.38)天、(8.39±2.52)天,术后疼痛程度低于微创肺叶组,差异均有统计学意义(P<0.05);微创肺段组与微创肺叶组患者术后并发症总发生率比较差异无统计学意义(P>0.05);随访结果显示2组患者均无复发及死亡病例。结论:对直径≤2 cm的I期肺癌,微创肺段切除术与微创肺叶切除术在术后并发症及远期效果上均较好,而微创肺段切除术相较于微创肺叶切除术可明显减少手术创伤。

Objective:To evaluate the clinical application value of minimally invasive lobectomy and segmentectomy in patients with early-stage lung cancer.Methods:153 patients with early-stage lung cancer who underwent minimally invasive lobectomy or segmentectomy in a hospital were selected as the study objects.Clinical data of these patients was retrospectively collected.The patients were divided,according to the different surgical methods,into two groups:minimally invasive lobectomy group(116 cases)and minimally invasive segmentectomy group(37 cases).Clinical data including general data,surgery-related information(intraoperative bleeding volume,surgical time consumption,total chest tube drainage,thoracic drainage tube placement time,postoperative pain score),hospitalization-related indicators(hospitalization cost,postoperative hospitalization time),postoperative complications and state of survival,were compared between the two groups.Results:The total chest tube drainage(700.41±479.30mL),thoracic drainage tube placement time(5.00±2.47 days)and postoperative hospitalization time(6.86±2.57 days)in the minimally invasive segmentectomy group were all better than(940.30±639.27mL),(6.21±2.38 days),(8.39±2.52 days)in the minimally invasive lobectomy group.In addition,postoperative pain score was lower in the minimally invasive segmentectomy group.All these differences were statistically significant(P<0.05).The rate of postoperative complications was similar between the two groups(P>0.05).The follow-up data showed no relapse or death in either group.Conclusion:For early-stage lung cancer with diameter less than or equal to 2cm,minimally invasive segmentectomy and lobectomy all work well in postoperative complications and long-term effects.However,minimally invasive segmentectomy can significantly reduce surgical trauma compared with minimally invasive lobectomy.