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作 者:王进[1] 戚剑伟[1] 火旭东[1] 王文才[1] WANG Jin;QI Jian-wei;HUO Xu-dong;WANG Wen-cai(Department of Thoracic Surgery,Yancheng Third People’s Hospital Affiliated to Southeast University,Yancheng 224000,Jiangsu,China)
机构地区:[1]东南大学附属盐城第三人民医院胸外科
出 处:《川北医学院学报》2019年第5期628-631,共4页Journal of North Sichuan Medical College
摘 要:目的:探讨胸腔镜下肺段切除术治疗I期非小细胞肺癌(NSCLC)的可行性,评估其近远期疗效。方法:将接受胸腔镜下肺段切除术(n=39)和肺叶切除术(n=46)的I期NSCLC患者,分别记为肺段组和肺叶组。比较两组手术临床指标、并发症及肺功能指标,术后随访3年,并评估其远期疗效。结果:两组手术时间、术中出血量、淋巴结清扫个数比较,差异无统计学意义(t=0.464、0.703、0.206,P>0.05),但肺段组胸腔引流时间、引流总量、住院时间均少于肺叶组(t=2.346、2.396、2.481,P<0.05),并发症发生率(5.13%)低于肺叶组(19.57%)(χ^2=3.905,P<0.05)。术后2周,两组患者肺功能FVC、FEV1、MVV和术前比较均有明显下降,但肺段组的FVC、FEV1、MVV高于肺叶组,差异均有统计学意义(t=2.477、2.322、2.562,P<0.05)。肺段组无瘤生存率(69.23%)、总生存率(82.05%)和肺叶组(69.57%、80.43%)接近,二者比较,差异均无统计学意义(χ^2=0.001、0.036,P>0.05)。结论:胸腔镜下肺段切除术和肺叶切除术均是治疗I期NSCLC的有效微创术式,但胸腔镜下肺段切除术效果更佳。Objective:To investigate the feasibility of thoracoscopic segmentectomy for stage I non-small cell lung cancer(NSCLC),and evaluate its short-term and long-term efficacy.Methods:Patients with stage I NSCLC who underwent thoracoscopic segmentectomy(n=39)and lobectomy(n=46)were divided into the lung segment group and the lung lobe group.The clinical indexes,complications and pulmonary function of the two groups were compared.The patients were followed up for 3 years and the long-term effect was evaluated.Results:There was no significant difference in operation time,intraoperative bleeding volume and number of lymph node dissection between the two groups(t=0.464,0.703,0.206,P>0.05),but the time of thoracic drainage,total drainage volume and hospitalization time in the lung segment group were less than those in the lobe group(t=2.346,2.396,2.481,P<0.05),and the incidence of complications(5.13%)was also lower than that in the lung lobe group(19.57%)(χ^2=3.905,P<0.05).Two weeks after operation,the lung function of FVC,FEV1,MVV in the two groups decreased significantly,but the FVC,FEV1 and MVV in the lung segment group were higher than those in the lung lobe group(t=2.477,2.322,2.562,P<0.05).Tumor-free survival rate(69.23%),total survival rate(82.05%)in the lung segment group were similar to these in the lobar lung group(69.57%,80.43%),and there was no significant difference between the two groups(χ^2=0.001,0.036,P>0.05).Conclusion:Thoracoscopic segmentectomy and lobectomy are effective minimally invasive procedures for stage I NSCLC,but the thoracoscopic segmentectomy is more effective.
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