全胸腔镜下与开胸肺叶切除术治疗早期肺癌疗效对比观察

Comparison of Efficacy of Total Thoracoscopic Lobectomy and Thoracotomy for Early Lung Cancer

目的探讨全胸腔镜肺叶切除术与传统开胸肺叶切除术对于早期非小细胞肺癌的临床疗效和安全性。方法采用随机对照试验的方法将50例早期(TNMⅠ/Ⅱ期)的非小细胞肺癌(NSCLC)患者随机分为胸腔镜组和开胸手术组,分别给予全胸腔镜下肺叶切除术和传统开胸肺叶切除术,比较2组患者的近期疗效指标、远期生存指标和手术的安全性。结果胸腔镜组术后引流时间、术后疼痛评分、平均住院时间显著低于开胸手术组(P<0.05),2组患者术中出血量、手术时间、淋巴结清扫数目无显著差异(P>0.05)。2组患者的远期生存率无显著差异(P>0.05)。胸腔镜组肺炎发生率显著低于开胸手术组(P<0.05),其他并发症发生率无显著差异(P>0.05)。结论与传统开胸肺叶切除术相比,全胸腔镜下手术能够缩短住院时间、减少手术创伤、减轻患者痛苦、降低并发症的发生率,且能够达到相同的近期和远期疗效,值得临床推广应用。

Objective To investigate clinical efficacy and safety of total thoracoscopic lobectomy and thoracotomy for early non-small cell lung cancer( NSCLC). Methods A randomized controlled trial was conducted through 50 cases of early( TNMⅠ/Ⅱ period) NSCLC patients,they were randomly divided into total thoracoscopic lobectomy surgery group( TLS group)and conventional thoracotomy lobectomy group( CTL group),which were given total thoracoscopic lobectomy surgery and conventional thoracotomy lobectomy respectively. Recent efficacy indicators,long-term survival indicators and safety of the 2 groups were compared. Results Postoperative drainage time,postoperative pain scores,the average length of stay of TLS group were significantly lower than those of the CTL group( P < 0. 05),while there was no significant differences between the 2 groups in blood loss,operative time,lymph nodes dissection number( P > 0. 05); and there was no significant difference in long-term survival rate between the 2 groups( P > 0. 05); incidence of pneumonia of TLS group was lower than that of CTL group,while there was no significant differences in other postoperative complications( P < 0. 05). Conclusion Compared with traditional thoracotomy lobectomy,total thoracoscopic surgery can shorten hospital stays,reduce surgical trauma,alleviate the suffering of patients and reduce the incidence of complications,and it can achieve the same short-term and long-term efficacy as traditional thoracotomy lobectomy,so it is worthy of clinical applications.