Iwasaki A, Shirakusa T, Hamada T, Inutsuka K, Maekawa T, Yoshinaga Y, Mikami K
Second Department of Surgery, School of Medicine, Fukuoka University, 45-1, 7-chome Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
Thorac Cardiovasc Surg. 2006 Aug;54(5):337-40. doi: 10.1055/s-2006-923930.
Patients with second primary lung cancer (SPLC) have a heterogeneous background. The optimum modality of treatment for SPLC patients has not yet been determined. The objective of this study was to attempt to identify the value of less vigorous therapies such as segmentectomy or video-assisted thoracic surgery (VATS) in SPLC.
We retrospectively reviewed the medical records of 46 patients who underwent resection for SPLC in Fukuoka University Hospital between January 1994 and April 2005. Patients were separated into two groups (LVT: less vigorous therapy including segmentectomy or VATS lobectomy; LCT: lobectomy with conventional thoracotomy). The characteristics of each group were evaluated and survival rates were analyzed at 5 years after surgery.
The mean amount of blood loss was found to be significantly different ( P = 0.0062) with 59.44 +/- 14.00 ml for LVT cases and 254.48 +/- 63.62 ml for LCT. None of the LVT patients experienced postoperative complications. The 5-year survival rate was 62.7 % for LVT and 57.7 % for LCT. There was no significant difference in survival rates between these groups.
Although differences were seen in the characteristics, less invasive surgery such as VATS or segmentectomy may be a feasible treatment for SPLC.
第二原发性肺癌（SPLC）患者背景各异。SPLC患者的最佳治疗方式尚未确定。本研究的目的是试图确定诸如肺段切除术或电视辅助胸腔镜手术（VATS）等创伤较小的治疗方法在SPLC中的价值。
我们回顾性分析了1994年1月至2005年4月在福冈大学医院接受SPLC切除术的46例患者的病历。患者被分为两组（LVT组：包括肺段切除术或VATS肺叶切除术的创伤较小的治疗方法；LCT组：传统开胸肺叶切除术）。评估每组的特征，并分析术后5年的生存率。
发现平均失血量有显著差异（P = 0.0062），LVT组为59.44±14.00 ml，LCT组为254.48±63.62 ml。LVT组患者均未发生术后并发症。LVT组的5年生存率为62.7%，LCT组为57.7%。两组之间的生存率无显著差异。
尽管在特征方面存在差异，但诸如VATS或肺段切除术等微创手术可能是SPLC的一种可行治疗方法。
