胸腔镜微创术治疗I期非小细胞肺癌的疗效及术后复发转移危险因素分析  

Therapeutic effect of thoracoscopic minimally invasive surgery on stage I non-small cell lung cancer and postoperative risk factors for recurrence and metastasis

作　　者：刘帅洲[1] 张世锋[1] LIU Shuai-zhou;ZHANG Shi-feng(Department of Cardiothoracic Surgery,Sanmenxia Central Hospital,Sanmenxia,Henan 472000,China)

机构地区：[1]河南省三门峡市中心医院心胸外科,河南三门峡472000

出　　处：《青岛医药卫生》2021年第3期173-176,共4页Qingdao Medical Journal

摘　　要：目的分析胸腔镜微创术治疗I期非小细胞肺癌(NSCLC)的疗效及术后复发转移危险因素。方法选择2014年11月至2018年7月本院收治的I期NSCLC患者270例,依据手术方式不同分为观察组(n=210,接受全胸腔镜肺叶切除术)和对照组(n=60,行常规开胸肺叶切除术),随访术后两年内复发与转移情况,分析复发转移危险因素。结果观察组手术时间、胸腔引流时间及住院时间均短于对照组,术中出血量、术后并发症发生率低于对照组,术后两年生存率高于对照组(P<0.05);纵隔淋巴结转移、低分化、肿瘤直径≥2.5 cm是I期NSCLC患者术后复发的危险因素(P<0.05),淋巴结转移数目、清扫淋巴结数目、术后放化疗情况为患者术后转移的独立危险因素(P<0.05)。结论胸腔镜微创手术治疗I期NSCLC的疗效优于常规开胸肺叶切除术,改善患者预后,但仍受纵隔淋巴结转移、肿瘤分化与直径等影响而出现复发转移,应加以重视。Objective To analyze the efficacy of thoracoscopic minimally invasive surgery on stage I non-small cell lung cancer(NSCLC)and the postoperative risk factors for recurrence and metastasis.Methods A total of 270 patients with stage I NSCLC treated in our hospital from November 2014 to July 2018 were selected.According to different surgical methods,they were divided into observation group(n=210,undergoing total thoracoscopic lobectomy)and the control group(n=60,undergoing routine open thoracotomy lobectomy).The recurrence and metastasis within 2 years after operation were recorded.The risk factors of recurrence and metastasis were analyzed.Results Compared with the control group,the operation time,chest drainage time and hospital stay of the observation group were significantly shorter,the intraoperative blood loss and incidence of postoperative complications were lower,and postoperative 2-year survival rate was higher(P<0.05).Univariate and multivariate logistic regression analysis found that mediastinal lymph node metastasis,poor differentiation and tumor diameter not less than 2.5 cm were risk factors for postoperative recurrence in patients with stage I NSCLC(P<0.05).The number of lymph node metastasis,the number of dissected lymph nodes and radiochemotherapy after operation were the independent risk factors for postoperative metastasis of patients(P<0.05).Conclusion The therapeutic effect of thoracoscopic minimally invasive surgery in the treatment of stage I NSCLC is superior to routine open thoracotomy lobectomy,which can improve the prognosis of patients.However,recurrence and metastasis are affected by factors such as mediastinal lymph node metastasis,tumor differentiation and tumor diameter.

关 键 词：胸腔镜微创术 I期 非小细胞肺癌 疗效 复发 转移 危险因素 

分 类 号：R655.3[医药卫生—外科学]