单操作孔电视胸腔镜与开胸肺癌根治术对早期肺癌淋巴结清扫及疗效的对比研究  

Comparison of single utility port complete video-assisted thoracoscopic surgery versus open lymphadenectomy for non-small cell lung cancer

作　　者：王光宇[1] 初向阳[1] 李国[1] 薛志强[1] 张连斌[1] 侯晓彬[1] 

机构地区：[1]解放军总医院胸外科,北京100853

出　　处：《中国医药》2014年第1期37-40,共4页China Medicine

摘　　要：目的探讨单操作孔电视胸腔镜肺癌根治术中区域淋巴结清扫的可行性、安全性及临床效果。方法收集2009年1月至2013年5月解放军总医院胸外科404例早期肺癌患者病历资料并进行回顾性分析。根据采用手术方式的不同分为单操作孔组（203例）和开胸组（201例），单操作孔组采用单操作孔电视胸腔镜肺叶切除术，开胸组采用常规开放肺叶切除术。比较2组术中清扫淋巴结数、转移的阳性淋巴结数、手术时间、术中出血量、术后带胸引管时间、住院时间及术后并发症等情况。结果单操作孔组清扫淋巴结数及淋巴结转移例数与开胸组的差异均无统计学意义（均P〉0．05）。单操作孔组术中出血量少于开胸组[（119±50）ml比（166±78）m1]，术后带管时间和术后住院时间短于开胸组[（4．9±2．2）d比（5．5±2．7）d，（10．1±2．6）d比（12．9±3．5）d]，术后并发症发生率低于开胸组[7．4％（15／203）比13．9％（28／201）]，组间差异均有统计学意义（均P〈0．05）。2组手术时间差异无统计学意义（P〉0．05）。结论单操作孔电视胸腔镜与常规开胸手术治疗早期非小细胞肺癌相比，具有安全、可靠、创伤小、恢复快等优势，而其淋巴结清扫范围及效果与传统开放手术相似。Objective To evaluate the safety and clinical outcomes of single utility port complete video- assisted thoraeoseopic surgery （VATS）lobectomy. Methods We retrospectively analyzed the clinical data of 203 consecutive patients with early-stage lung cancer who underwent single utility POrt complete VATS lobectomy from January 2009 to May 2013 in Chinese PLA general hospital （single utility port group）. 201 patients with earlystage lung cancer who underwent open surgery lobectomy in the same period （open surgery group）were enrolled as a control group. The clinical outcomes including lymph node dissection number, operation time, intraoperative blood loss, chest drainage duration, hospitalization time and postoperative complications were compared between the two groups. Results There were statistical differences in the intraoperative blood loss [ （ 119 ± 50 ） ml vs （ 166 ± 78 ） ml ], chest drainage duration [ （4.9 ± 2.2 ） d vs （ 5.5 ± 2.7 ） d ], hospitalization time [ （ 10.1 ± 2.6 ） d vs（ 12.9 ± 3.5 ） d ] and incidence of serious postoperative complications [ 7.4% （ 15/203 ） vs 13.9% （ 28/201 ） ] between the two groups （ all P 〈 0.05 ）. There was no statistical difference in operation time and lymph node dissection number between the two groups （ P 〉 0.05 ）. Conclusions Single utility port complete VATS lobectomy and lymph node dissection are safe and reliable for patients with early-stage lung cancer with less injury and better postoperative recovery, compared with open surgery. Lymphadenectomy outcome related to this therapy is as good as open surgery.

关 键 词：肺肿瘤 胸外科手术 电视辅助 单操作孔 淋巴结清扫 

分 类 号：R734.2[医药卫生—肿瘤]