全胸腔镜下非小细胞肺癌淋巴结清扫的临床研究  

Video-assisted Thorascopic Lymphadenectomy for Non-small Cell Lung Cancer

作　　者：张铁娃[1] 禹亮[1] 姜久仰[1] 王胜发[1] 

机构地区：[1]哈尔滨医科大学附属第一医院胸外科,哈尔滨150001

出　　处：《中国微创外科杂志》2009年第8期696-699,共4页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨电视胸腔镜下非小细胞肺癌根治术中区域淋巴结清扫的临床效果。方法选取我院2007年5月～2008年10月31例周围型非小细胞肺癌,在全胸腔镜(VATS组,n=14)及胸腔镜辅助小切口(VAMT组,n=17)下行肺癌根治术,比较2组术中清扫淋巴结数、转移的阳性淋巴结数及术后随访情况。结果2组患者无围手术期死亡及严重围手术期并发症,VATS组手术时间(193±92)min与VAMT组(188±101)min相比无统计学差异(t=0.143,P=0.887),VATS组术中出血量(592±123)ml与VAMT组(648±120)ml相比无统计学差异(t=-1.297,P=0.211),VAMT组每例清扫淋巴结数(14.6±7.5)枚与VATS组(15.2±4.5)枚无统计学差异显著性(t=0.262,P=0.795),术后1年内复发或转移率VATS组(3/14,21.4%)与VAMT组(2/15,13.3%)相比无统计学差异(P=0.651)。结论全胸腔镜下肺癌根治术不辅加胸部小切口,在减少创伤的同时可完成标准的肺癌根治术。Objective To study the reliability and feasibility of video-assisted thorascopic lymphadenectomy for complete resection of non-small cell lung cancer （ NSCLC）. Methods From May 2007 to October 2008, 31 patients with NSCLC underwent video-assisted thorascopic radical lobectomy combined with systemic lymphadenectomy in our hospital. The patients were divided into video-assisted thorascopic surgery （VATS） group （n = 14） and video-assisted mini-thoracotomy （VAMT） group （n = 17）. The numbers of removed and metastatic lymph nodes were counted. The results and the follow-up outcomes were compared between the two groups. Results No patient dead or showed serious perioperative complications in both the groups. No significant differences were found between the VATS and VAMT groups in the operation time [（193 ±92） min vs （188±101） min, t=0.143, P=0.887], blood loss [（592±123） ml vs （648 ±120） ml, t = -1.297, P=0.211], number of removed lymph nodes [（14.6 ±7.5） vs （15.2±4.5）, t=0.262, P=0.795],orl-year rate of recurrence or metastasis [21.4% （3/14） vs 13.3%（2/15）, P=0.651]. Conclusion For patients with NSCLC, no significant difference exists between the outcomes of video-assisted thoraseopic surgery and video-assisted mini-thoracotomy.

关 键 词：非小细胞肺癌 电视胸腔镜手术 胸腔镜辅助小切口 淋巴结清扫术 

分 类 号：R734.2[医药卫生—肿瘤]