Background: Some studies have suggested that among all cases of lung cancer, the outcome of lung cancer located in the right middle lobe (RML) is the worst. However, with the advances in the diagnosis and treatment me...Background: Some studies have suggested that among all cases of lung cancer, the outcome of lung cancer located in the right middle lobe (RML) is the worst. However, with the advances in the diagnosis and treatment methods of lung cancer over the last couple of decades, we investigated whether the prognosis of primary lung cancer located in the RML still remains inferior to that of lung cancer arising from other lobes. Methods: Between July 2003 and December 2011, 505 consecutive patients with non-small cell lung cancer (NSCLC) underwent surgical resection at our institution. Of these, 32 patients (6.3%) had tumors arising from the RML. Results: The rate of incomplete resection was higher for cancer located in the RML than that for cancer arising from other lobes. Significant associations were noted between cancer located in the RML and the rate of lymph node metastasis and initial locoregional recurrence. Multivariate analysis identified lymph node metastasis and location in the RML as independent risk factors influencing the recurrence-free survival (p = 0.006), although location in the RML was not extracted as an independent risk factor influenceing the overall survival (p = 0.060). Conclusion: Despite the recent advances in the treatment of lung cancer, evaluation of complete resection revealed that the outcome of cancer located in the RML is still the worst among cancer of all the lobes. Further early diagnosis and adjuvant therapy are needed for improving the prognosis of cancer located in the RML.展开更多
目的探讨两种手术入路,在电视胸腔镜右上肺叶切除术中的可行性以及对术后康复的影响。方法收集2017年1月1日至2019年10月31日86例行右肺上叶切除患者的临床资料。按两种手术入路,将患者分为AVB(动脉-静脉-支气管)组46例和aBVA(后升支动...目的探讨两种手术入路,在电视胸腔镜右上肺叶切除术中的可行性以及对术后康复的影响。方法收集2017年1月1日至2019年10月31日86例行右肺上叶切除患者的临床资料。按两种手术入路,将患者分为AVB(动脉-静脉-支气管)组46例和aBVA(后升支动脉-支气管-动静脉)组40例,分析比较两组患者的一般临床特征、病理结果、术中情况及术后康复情况。结果与AVB组相比,aBVA组在手术时间(138.4 vs 181.6 min,P<0.001)、术中失血(113.0 vs 196.5 mL,P<0.001)、切割闭合器钉仓数量(4.0 vs 5.4,P<0.001)、胸腔引流时间(3.6 vs 4.8 d,P<0.001)、住院时间(6.2 vs 7.8 d,P=0.001)、住院总费用(61000 vs 69000元,P=0.001)等方面具有显著优势。在术后并发症方面,两组发生率无统计学差异(15.2%vs 12.5%,P=0.717)。结论电视胸腔镜下右肺上叶切除,采用aBVA解剖入路安全可行,在一定程度上可以降低手术风险,简化手术流程,利于患者术后快速康复。展开更多
文摘Background: Some studies have suggested that among all cases of lung cancer, the outcome of lung cancer located in the right middle lobe (RML) is the worst. However, with the advances in the diagnosis and treatment methods of lung cancer over the last couple of decades, we investigated whether the prognosis of primary lung cancer located in the RML still remains inferior to that of lung cancer arising from other lobes. Methods: Between July 2003 and December 2011, 505 consecutive patients with non-small cell lung cancer (NSCLC) underwent surgical resection at our institution. Of these, 32 patients (6.3%) had tumors arising from the RML. Results: The rate of incomplete resection was higher for cancer located in the RML than that for cancer arising from other lobes. Significant associations were noted between cancer located in the RML and the rate of lymph node metastasis and initial locoregional recurrence. Multivariate analysis identified lymph node metastasis and location in the RML as independent risk factors influencing the recurrence-free survival (p = 0.006), although location in the RML was not extracted as an independent risk factor influenceing the overall survival (p = 0.060). Conclusion: Despite the recent advances in the treatment of lung cancer, evaluation of complete resection revealed that the outcome of cancer located in the RML is still the worst among cancer of all the lobes. Further early diagnosis and adjuvant therapy are needed for improving the prognosis of cancer located in the RML.
文摘目的探讨两种手术入路,在电视胸腔镜右上肺叶切除术中的可行性以及对术后康复的影响。方法收集2017年1月1日至2019年10月31日86例行右肺上叶切除患者的临床资料。按两种手术入路,将患者分为AVB(动脉-静脉-支气管)组46例和aBVA(后升支动脉-支气管-动静脉)组40例,分析比较两组患者的一般临床特征、病理结果、术中情况及术后康复情况。结果与AVB组相比,aBVA组在手术时间(138.4 vs 181.6 min,P<0.001)、术中失血(113.0 vs 196.5 mL,P<0.001)、切割闭合器钉仓数量(4.0 vs 5.4,P<0.001)、胸腔引流时间(3.6 vs 4.8 d,P<0.001)、住院时间(6.2 vs 7.8 d,P=0.001)、住院总费用(61000 vs 69000元,P=0.001)等方面具有显著优势。在术后并发症方面,两组发生率无统计学差异(15.2%vs 12.5%,P=0.717)。结论电视胸腔镜下右肺上叶切除,采用aBVA解剖入路安全可行,在一定程度上可以降低手术风险,简化手术流程,利于患者术后快速康复。
