胸腔镜肺亚叶切除术治疗Ⅰ期高龄非小细胞肺癌患者的回顾性研究  

Thoracoscopic sublobar resection in elderly patients with stage I non-small cell lung cancer

作　　者：沈海波[1] 胡天军[1] 杨振华[1] 

机构地区：[1]宁波市第二医院胸外科,315010

出　　处：《浙江医学》2014年第3期215-217,共3页Zhejiang Medical Journal

摘　　要：目的探讨胸腔镜肺亚叶切除术治疗Ⅰ期高龄非小细胞肺癌患者的临床疗效。方法将行手术治疗且术后病理为I期非小细胞肺癌的126例年龄>70岁的患者分为胸腔镜肺亚叶切除术组(59例)和胸腔镜肺叶切除术组(67例),分析比较两组患者的年龄分布情况、术后并发症、术后引流时间、住院天数及术后随访情况。结果 >75岁患者多选择胸腔镜肺亚叶切除术。胸腔镜肺叶切除术患者总体并发症发生率(40 7%)显著高于胸腔镜肺亚叶切除术患者(1 9.4%),差异有统计学意义(P=0 047)。胸腔镜肺亚叶切除术患者的平均术后引流时间、住院天数[(3 3±1.0)d、(8.5±1 5)d]短于胸腔镜肺叶切除术患者[(44±2.0)d、(12.8±2.0)d],差异均有统计学意义(均P<0.01)。两组患者2、3年生存率的差异均无统计学意义(均P>0.05)。结论胸腔镜肺亚叶切除术治疗老年I期非小细胞肺癌安全性良好,预后与肺叶切除术相似,可以作为老年Ⅰ期非小细胞肺癌患者尤其是不能耐受肺叶切除者一个较好的选择。Objective To evaluate the efficacy of thoracoscopic sublobar resection in elderly patients with stage I non- smal celllung cancer （NSCLC）. Methods One hundred and twenty six patients with stage I NSCLC aged＆gt;70y underwent thoracoscopic resection in our hospital between October 2008 and October 2011, including 67 cases with thoracoscopic sublo-bar resection （study group）, and 59 cases with thoracoscopic lobectomy （control group）. The age distribution, postoperative complications, chest tube maintenance time, length of hospital stay and the fol ow- up data were retrospectively reviewed and compared between two groups. Results Patients aged＆gt;75y were more likely to choose sublobar resection. The total compli-cation rate in control group was significantly higher than that in study group （40.7%vs 19.4%, P=0.047）. The chest tube mainte-nance time and length of hospital stay was longer in control group than in those study group （4.4±2.0d vs 3.3±1.0d, and 12.8± 2.0d vs 8.5±1.5d, respectively;both P〈0.01）. There was no significant difference in estimated 2- and 3- year survival rate be-tween two groups （P＆gt;0.05）. Conclusion Thoracoscopic sublobar resection can be performed safely in elderly patients with stage I NSCLC and the clinical efficacy is comparable with the thoracoscopic lobectomy.

关 键 词：I期非小细胞肺癌 高龄患者 胸腔镜亚叶切除 

分 类 号：R734.2[医药卫生—肿瘤]