荧光胸腔镜辅助肺动静脉临时阻断定位亚肺叶切除术治疗早期非小细胞肺癌的近期效果评估  

Evaluation of the short-term efficacy of fluorescence thoracoscopy-assisted temporary occlusion of pulmonary arteries and veins in sublobar resection for early-stage non-small cell lung cancer

作　　者：赵彦 游宾 李辉 Zhao Yan;You Bin;Li Hui(Department of Thoracic Surgery,Beijing Chao-Yang Hospital,Capital Medical University,Beijing Institute of Respiratory Medicine,Beijing 100020,China;Department of Thoracic Surgery,Beijing An-Zhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京朝阳医院,北京市呼吸疾病研究所胸外科,北京100020 [2]首都医科大学附属北京安贞医院胸外科,北京100029

出　　处：《中华外科杂志》2025年第2期124-129,共6页Chinese Journal of Surgery

摘　　要：目的探讨荧光胸腔镜辅助肺动静脉临时阻断定位亚肺叶切除术治疗早期非小细胞肺癌的近期效果。方法本研究为前瞻性队列研究。纳入2024年1月至4月于首都医科大学附属北京朝阳医院胸外科接受荧光胸腔镜辅助肺动静脉临时阻断定位亚肺叶切除术的早期非小细胞肺癌患者。根据术中阻断肺动脉还是肺静脉, 将患者分为动脉组和静脉组。收集并比较两组患者的手术时间、术中出血量、病灶距切缘的距离、边界持续时间等。采用独立样本t检验、Mann-WhitneyU检验或χ^(2)检验比较两组间资料的差异。结果研究共纳入64例患者, 其中男性25例, 女性39例, 年龄(57.3±12.1)岁(范围:34~80岁), 肿瘤最大径为(9.8±2.9)mm(范围:5~16 mm)。手术均顺利完成, 手术切缘与病灶的距离为(16.5±3.9)mm(范围:10~30 mm), 手术时间为(61.5±13.9)min(范围:30~120 min)。病理学检查结果示切缘均达到肿瘤学要求要求。胸腔引流管留置时间M(IQR)为2(1)d(范围:1~7 d), 术后无严重并发症发生。动脉组(n=23)和静脉组(n=41)的边界持续时间分别为(147.9±22.2)s(范围:119~188 s)和(40.9±8.0)s(范围:20~60 s)(t=27.935, P<0.01)。结论荧光胸腔镜辅助动静脉临时阻断定位法能够有效且准确地定位手术切除范围, 确保足够的切缘距离, 符合肿瘤学要求。ObjectiveTo investigate the effectiveness and safety of fluorescence thoracoscopy-assisted temporary occlusion of pulmonary arteries and veins during sublobar resection for the treatment of early-stage non-small cell lung cancer(NSCLC).MethodsThis is a prospective cohort study.Patients with early-stage NSCLC who underwent fluorescence thoracoscopy-assisted temporary occlusion of pulmonary arteries and veins for sublobar resection in the Department of Thoracic Surgery,Beijing Chaoyang Hospital,Capital Medical University,from January to April 2024 were included.Based on whether the artery or vein was blocked during surgery,the patients were divided into the arterial group and the venous group.The surgical time,intraoperative blood loss,distance from the lesion to the resection margin,and boundary duration were collected and compared between the two groups.Independent sample t test,Mann-Whitney U test,orχ^(2) test was used to compare the data between the two groups.ResultsA total of 64 patients were enrolled.There were 25 males and 39 females,aged(57.3±12.1)years(range:34 to 80 years).The tumor diameter was(9.8±2.9)mm(range:5 to 16 mm).The distance between the surgical margin and the lesion was(16.5±3.9)mm(range:10 to 30 mm)and the surgical time was(61.5±13.9)minutes(range:30 to 120 minutes).Pathological examination of the surgical specimens showed that all margins met pathological requirements.The chest drainage tube retention time(M(IQR))was 2(1)days(range:1 to 7 days),and no serious postoperative complications occurred.The boundary duration for the arterial group(n=23)and venous group(n=41)was(147.9±22.2)seconds(range:119 to 188 seconds)and(40.9±8.0)seconds(range:20 to 60 seconds),respectively(t=27.935,P<0.01).ConclusionFluorescence thoracoscopy-assisted temporary occlusion of pulmonary arteries and veins can effectively and accurately delineate surgical resection boundaries,ensuring sufficient margin width to meet oncological requirements.

关 键 词：癌 非小细胞肺 胸腔镜 肺循环临时阻断 亚肺叶切除术 

分 类 号：R734.2[医药卫生—肿瘤]