电视辅助胸腔镜手术（VATS）肺叶切除术：循证依据
Video-assisted thoracic surgery (VATS) lobectomy: the evidence base.
作者信息
Alam Naveed, Flores Raja M
机构信息
Peter MacCallum Cancer Centre and St. Vincent's Hospital, Melbourne, Australia.
出版信息
JSLS. 2007 Jul-Sep;11(3):368-74.
BACKGROUND
Video-assisted thoracic surgery (VATS) lobectomy provides a minimally invasive alternative for management of early stage non-small cell lung cancer, but is still only performed in a few specialized centers around the world. Questions about the safety of the surgery and its adequacy as a cancer operation remain hurdles for many surgeons.
METHODS
We performed a systematic review of the literature on VATS lobectomy to assess these questions. The MEDLINE database was queried and the papers analyzed.
RESULTS
Four randomized control trials, 11 case-control series, and 10 case series were reviewed. A variety of VATS techniques are used, making generalization of results difficult. The weight of this evidence suggests that VATS lobectomy can be safely performed and is an adequate cancer operation for early stage non-small cell lung cancer. There is also evidence that patients experience less pain with VATS, but that length of hospital stay is similar.
CONCLUSION
In expert hands, VATS lobectomy appears to be a safe procedure. However, the published evidence is thin and ongoing study is required, preferably with standardization of VATS techniques.
背景
电视辅助胸腔镜手术（VATS）肺叶切除术为早期非小细胞肺癌的治疗提供了一种微创替代方法，但目前仍仅在全球少数几个专业中心开展。对于许多外科医生而言，该手术的安全性及其作为癌症手术的充分性问题仍是障碍。
方法
我们对关于VATS肺叶切除术的文献进行了系统回顾，以评估这些问题。检索了MEDLINE数据库并分析了相关论文。
结果
共回顾了4项随机对照试验、11个病例对照系列和10个病例系列。VATS技术多种多样，使得结果难以归纳总结。现有证据表明，VATS肺叶切除术可以安全实施，且对于早期非小细胞肺癌是一种充分的癌症手术。也有证据表明，VATS手术患者的疼痛较轻，但住院时间相似。
结论
在专家手中，VATS肺叶切除术似乎是一种安全的手术方法。然而，已发表的证据较少，需要持续开展研究，最好对VATS技术进行标准化。
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