胸腔镜在Ⅰ、Ⅱ、Ⅲ期肺癌根治术中的临床应用  

The clinical application of video-assisted thoracoscope surgery in phase Ⅰ, Ⅱ, Ⅲ lung cancer radical resection

作　　者：胡德宏[1] 董顺军 卢恒孝[1] 李伟[1] 胡国栋[1] 翟春波[1] 赵强[1] 张振江[1] 

机构地区：[1]山东省潍坊市人民医院胸外科,山东潍坊261041

出　　处：《中国内镜杂志》2013年第11期1150-1153,共4页China Journal of Endoscopy

摘　　要：目的探讨电视辅助胸腔镜手术（VATS）在Ⅰ、Ⅱ、Ⅲ期肺癌根治术中临床疗效，初步探讨胸腔镜手术在局部晚期肺癌中的应用价值。方法于2009年6月～2012年10月行胸腔镜肺癌根治术患者中，随机选取术后病理分期为Ⅰ期的患者40例，Ⅱ期40例，11I期40例，比较3组术前、术中、术后临床资料，并做统计学分析。结果3组患者均无术中输血及中转开胸，围手术期无死亡病例。术前一般临床资料差异无显著性（P〉0．05），Ⅰ期组与Ⅱ期组术中及术后资料各项差异无显著性（P〉0．05），Ⅲ期组肺叶切除时间、淋巴结清扫时间、手术总时间均长于Ⅰ期及Ⅱ期组（P〈0．05），淋巴结清扫数目、站数、术中出血量、术后引流量、术后带管时间、住院天数、术后并发症差异无显著性（P〉0．05）。结论胸腔镜在Ⅰ期及Ⅱ期肺癌根治术中有着明显的优势，Ⅲ期肺癌并非胸腔镜手术禁忌证，某些局部晚期肺癌胸腔镜手术亦可达到根治目的，但手术风险也相应增高。[ Objective ] To study the clinical efficacy of radical resection of pulmonary carcinoma by using video assisted thoracoscopy surgery （VATS） in phase Ⅰ,Ⅱ,Ⅲ lung cancer, to get a preliminary discussion of thoracoscope technology application value in locally advanced lung cancer. [ Methods ] Among the lung cancer radical surgery cases by using VATS from July 2009 to October 2012, we randomly selected the pathological phase I 40 cases, phase ,Ⅱ 40 cases, phase Ⅲ 40 cases. The three groups of preoperative, intraoperative and postoperative clinical data were compared and analyzed statistically. [ Results ] There were no intraoperative blood transfusion, transit tboraco- tomy cases and perioperative deaths in three groups of patients. Three groups by the pairwise comparison, there were no difference in preoperative clinical data （P 〉0.05）. Intraoperative and postoperative data of phase I and phase 1I group had no obvious difference （P 〉0.05）. Compared with phase I and phase 1I group, lobectomy time, lymph node cleaning time, total operation time for stage Ⅲ group was longer （P 〈0.05）, however, number of cleaned lymph node, stand number, blood loss, postoperative drainage volume, postoperation, time with pipe, hospital stay and postopera- tive complications had no obvious difference （P 〉0.05）. [ Conclusion ] Thoracoscope in phase I and phase 1I lung cancer radical has obvious advantages, stage HI is not thoracoscope surgery contraindications. Some local advanced lung cancer thoracoscope surgery can achieve radical cure, but the operation risk also increased accordingly.

关 键 词：电视胸腔镜 肺叶切除 非小细胞肺癌 局部晚期肺癌 

分 类 号：R734.2[医药卫生—肿瘤]