胸腔镜肺段切除和肺叶切除在治疗早期非小细胞肺癌近期疗效的对比  

Comparison of Short-term Effect of Complete Video-assisted Thoracoscopic Anatomic Segmentectomy and Video-assisted Thoracoscopic Lobectomy for Early Stage Non-small Cell Lung Cancer

作　　者：庞景灼[1] 巫国勇[2] 叶敏[1] 庞文广[1] 蔡成杰[1] 

机构地区：[1]江门市中心医院胸外科,广东江门529030 [2]中山大学附属第一医院胸外科,广东广州510080

出　　处：《中山大学学报（医学科学版）》2015年第4期585-589,共5页Journal of Sun Yat-Sen University:Medical Sciences

摘　　要：【目的】了解胸腔镜解剖性肺段切除在治疗早期非小细胞肺癌的近期疗效中是否优于全胸腔镜肺叶切除,为将来比较其两者的远期疗效打下基础。【方法】将直径小于2 cm的早期肺癌随机分成胸腔镜解剖性肺段切除组和全胸腔镜肺叶切除组,并进行相应的手术切除。比较两组住院手术期间的各项指标(手术时间、手术出血量、术后住院时间、住院费用、术后并发症)和术后1年死亡率复发率、术后1年肺功能(FVC、FEV1、MVV)减少比率。【结果】肺段切除组在手术时间上要长于肺叶切除组(P<0.05),但在术后住院时间上优于肺叶切除组(P<0.01);两组在手术出血量、住院费用、术后并发症方面无明显统计学差异(P>0.05);两组在术后1年随访中,未发现死亡病例,亦未发现肿瘤复发转移病例;肺段切除组在术后1年肺功能减少比率中明显优于肺叶切除组(P<0.01)。【结论】全胸腔镜解剖性肺段切除在治疗早期非小细胞肺癌中近期疗效良好。肺段切除能保留更多的肺功能,可考虑作为年老患者或肺功能较差的患者的首选。【Objective】To investigate whether the short-term effect of complete video-assisted thoracoscopic anatomic segmentectomy is better than video-assisted thoracoscopic lobectomy for early stage non-small cell lung cancer. To lay the foundation for comparing the long-term effect. 【Methods】 We randomly divide the patients with early stage non-small cell lung cancer which diameter was less 2cm into two groups ：the complete video-assisted thoracoscopic anatomic segmentectomy group and video-assisted thoracoscopic lobectomy group. We compare the operative situation（the operative time, the intraoperative bleeding, the postoperative hospitalization time, the hospitalization expenses, the postoperative complications）, the mortality and recurrence rate after one year,the decrement rate of lung function after one year. 【Results】 Compared to video-assisted thoracoscopic lobectomy,the operative time was longer（P 0.05） and the postoperative hospitalization time was lesser（P 0.01） in complete video-assisted thoracoscopic anatomic segmentectomy.The intraoperative bleeding, the hospitalization expenses and the postoperative complications had no statistical discrepancy（P 0.05）. We find no relapse and metastasis case after one year in both groups. The decrement rate of lung function was much better in complete video-assisted thoracoscopic anatomic segmentectomy. 【Conclusion】 The short-term effect is well for the complete video-assisted thoracoscopic anatomic segmentectomy which can remain more lung function. So it can be the first choice operative method for old or the patient with poor lung function.

关 键 词：胸腔镜肺叶切除 解剖性肺段切除 非小细胞肺癌 

分 类 号：R615[医药卫生—外科学]