肺段切除术与肺叶切除术对小于2 cm的浸润性肺癌的疗效对比

Comparison of Segpectomy and Lobectomy in Invasive Lung Cancer Less than 2 cm

目的对比肺段切除术与肺叶切除术治疗直径<2 cm的浸润性肺癌的效果。方法选择2016年2月至2020年2月在无锡市人民医院就诊的直径<2 cm的浸润性肺癌(n=100)患者纳入研究,随机分为两组(观察组和对照组)。对照组(n=50)接受胸腔镜下肺叶切除术治疗,观察组(n=50)接受胸腔镜下肺段切除术治疗。观察两组患者的总有效率、手术效果、并发症发生情况、远期生存率;比较术前、术后患者的用力肺活量(FVC)和第1秒用力呼气容积(FEV_(1))。结果与对照组的总有效率72.00%相比,观察组的总有效率为94.00%,组间差异有统计学意义(P<0.05)。两组拔管天数、24 h引流量差异无统计学意义(P>0.05)。与对照组相比,观察组手术时间短,术中出血量少,住院时间短(P<0.05)。术后,两组FVC、FEV_(1)均降低,观察组FVC、FEV_(1)高于对照组(P<0.05)。与对照组相比,观察组并发症发生率低(P<0.05)。两组复发率相比,差异无统计学意义(P>0.05)。结论胸腔镜下肺段切除术治疗直径<2 cm浸润性肺癌疗效确切,该术式能缩短手术时间,术中出血量少,恢复速度快,远期肺功能保存更多,且与肺叶切除术相比,肺段切除术术后并发症少,且不增加复发风险,特别适用于对肺叶切除术不耐受合并基础疾病的高龄患者。

Objective To compare the effect of segpectomy and lobectomy in invasive lung cancer with diameter<2 cm.Methods The patients with invasive lung cancer(n=100)with diameter<2 cm who visited Wuxi People’s Hospital from February 2016 to February 2020 were selected as the research objects and they were divided into two groups(observation group and control group)according to the random method.The control group(n=50)was treated with thoracoscopic lobectomy,and the observation group(n=50)was treated with pulmonary segmental resection.The overall response efficiency,surgical effect,complications and long-term survival rate were observed,and the forced vital capacity(FVC)and forced expiratory volume in one second(FEV_(1))were compared.Results Compared with 72.00%of the control group,the total response rate of the patients of the observation group was 94.00%,which showed a great difference between the groups(P<0.05).There was no statistical difference in the days of extubation and 24 hours drainage rate between the two groups(P>0.05).Compared with the control group,the observation group had a shorter surgical time,less intraoperative bleeding,and a shorter hospital stay,with a statistically significant difference(P<0.05).After surgery,FVC and FEV_(1) were decreased in both groups,and FVC and FEV_(1) in the observation group were higher than that in the control group(P<0.05).The complication rate was low in the observation group compared to the control group(P<0.05).There was no statistical difference in recurrence rate between the two groups(P>0.05).Conclusion Thoracoscopic segmentectomy has a definite effect in the treatment of invasive lung cancer with diameter<2 cm.This operation has short operation time,less intraoperative bleeding,fast recovery,and more long-term lung function preservation.Compared with lobectomy,segmentectomy has fewer postoperative complications,and does not increase the risk of recurrence.It is especially suitable for elderly patients who are intolerant of lobectomy and have basic diseases.