原发性支气管肺癌电视胸腔镜下肺叶切除术后的早期疗效分析  

The early outcome of video-assisted thoracic surgery lobectomy for primary lung carcinoma

作　　者：杨健[1] 姜格宁[1] 高文[1] 童稳圃[1] 朱余明[1] 汪浩[1] 谢博雄[1] 

机构地区：[1]同济大学附属上海市肺科医院胸外科,200433

出　　处：《中华外科杂志》2007年第8期546-548,共3页Chinese Journal of Surgery

摘　　要：目的探讨电视胸腔镜肺叶切除术治疗原发性支气管肺癌的早期疗效。方法 1997年6月到2004年12月间治疗121例Ⅰ、Ⅱ期肺癌患者,其中Ⅰ期101例,右上叶切除术为34例,右中叶为13例,右下叶为17例;左上叶切除术为21例,左下叶为16例。病理分型:鳞癌24例,腺癌59例,细支气管肺泡癌10例,腺鳞混合癌7例,梭形细胞癌1例。全部使用胸腔镜器械切除的有38例。结果无术中死亡,并发症发生率15%。Ⅰ期患者的术后生存率:1年为99%(76/77),2年为96%(49/51),3年为79%(15/19),腺癌相对于其他类型肺癌在术后生存率方面差异有统计学意义(P<0.01),38例全部使用电视胸腔镜手术器械切除与63例胸腔镜辅助下小切口手术者在术后牛存率方面差异无统计学意义(P>0.05),与同期传统开胸手术相比亦如此。结论电视胸腔镜肺叶切除手术治疗早期肺癌的疗效优于传统开胸手术。Objective To evaluate the early outcome of patients who underwent video-assisted thoracic surgery （VATS） lobectomy for primary lung carcinoma. Methods The records of 121 patients with lung cancer undergoing VATS lung resection from 1997 to 2004 were reviewed retrospectively, Ⅰ stage：101 cases,34 cases underwent right upper lobectomy, 13 cases underwent right middle lobectomy, 17 cases underwent right down lobectomy,21 cases underwent left upper lobectomy, 16 cases underwent left down lobectomy. Thirty-eight cases underwent VATS lobectomy without assisted mini-incison. Results There were 18 cases of morbidities （ 15% ） and no surgical mortality. The 1-year ,2-year and 3-year survival rates of primary non-small cell lung cancer with Ⅰ stage is： 99% （76/77）,96% （49/51） and 79% （15/19）, respectively. There are statistic difference （P 〈 0. 01 ）between adenocarcinoma and the others. There are no statistic difference （ P 〉 0. 05 ） between the VATS lobectomy with assisted mini-incision（ n = 38 ） and without （ n = 63 ）, also no statistic difference （ P 〉 0.05 ） between the VATS lobectomy and the standard procedure. Conclusion Our findings suggest that VATS lobectomy is superior regarding its ability to achieve the same survival rates and little morbidities in comparison with the standard procedure.

关 键 词：癌 支气管原 胸腔镜 肺切除术 治疗效果 

分 类 号：R734.2[医药卫生—肿瘤]