胸腔镜肺叶切除术治疗非小细胞肺癌的疗效分析  

Operative Outcomes of Video-Assisted Thoracoscopic Lobectomy for Non-small Cell Lung Cancer

作　　者：王伟[1] 李学昌[1] 尚立群[1] 宋伟安[1] 文峰[1] 李军[1] 刘军强[1] 查鹏[1] 岳彩迎[1] 

机构地区：[1]中国人民解放军海军总医院胸外科,北京100048

出　　处：《肿瘤防治研究》2017年第8期540-543,共4页Cancer Research on Prevention and Treatment

摘　　要：目的探讨胸腔镜肺叶切除术治疗非小细胞肺癌的安全性、可靠性及疗效。方法回顾性分析海军总医院116例采用电视胸腔镜行肺叶切除术的Ⅰ~Ⅲa期非小细胞肺癌临床资料,其中男62例、女54例;中位年龄:(59.5±11.9)岁(范围:35~82岁)。采用Kaplan-Meier法对随访结果进行生存率统计。结果无围术期死亡。手术时间64~276 min,出血量60~560 ml,术后住院时间5~12天。11例患者围术期发生并发症,均经对症处理恢复,平均清扫淋巴结12~31枚。随访期间共死亡11例,4例失访。116例患者5年总生存率:Ⅰ期77.6%、Ⅱ期42.4%、Ⅲa期20.8%。结论胸腔镜肺叶切除术创伤小、疼痛轻,术后恢复快、住院时间短。生存率与开胸手术相当,已成为早中期肺癌治疗的标准术式。Objective To evaluate the safety, efficacy and clinical outcomes of complete video-assisted thoracoscopic lobectomy on non-small cell lung cancer（NSCLC）. Methods We retrospectively analyzed the clinical data of 116 NSCLC patients （62 male, 54 female, median age： （59.5±11.9） years old, range： 35-82 years old） who underwent complete video-assisted thoracoscopic lobectomy in the Navy General Hospital of PLA. The survival rates from the follow-up data was analyzed and calculated by Kaplan-Meier method. Results No perioperative mortality was observed. Operation time was 64-276 min and intraoperative blood loss was 60-560 ml. Postoperative hospital stay was 5-12days. Eleven patients had postoperative complications and were all cured by conservative treatment. Mean number of dissected lymph nodes was 12-31. A total of 11 patients were dead and four patients were lost during the follow-up. Overall 5-year survival rates were 77.6% for stage I, 42.4% for stage Ⅱ and 20.8% for stage Ⅲ, respectively. Conclusion The advantages of videoassisted thoracoscopic lobectomy include smaller surgical incision, less injury and postoperative pain, quicker postoperative recovery and shorter hospital stay. Long-term survival rate is comparable to open thoracotomy. Video-assisted thoracoscopic lobectomy can anatomically achieve complete tumor resection and systematic lymph node dissection, and it has become a standard surgical procedure for early and middle stage NSCLC patients.

关 键 词：电视胸腔镜肺叶切除术 非小细胞肺癌 系统淋巴结清扫 生存率 

分 类 号：R734.2[医药卫生—肿瘤]