Obuchi T, Imakiire T, Hamatake D, Nakashima H, Hamanaka W, Yanagisawa J, Shiraishi T, Iwasaki A
Department of Thoracic Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
Asian J Endosc Surg. 2011 Nov;4(4):157-60. doi: 10.1111/j.1758-5910.2011.00099.x. Epub 2011 Aug 3.
In recent years, the number of hemodialysis patients has been continuously increasing. At the same time, the use of video-assisted thoracic surgery (VATS) for lung cancer has also increased. However, reports of the outcome of VATS in hemodialysis patients are still quite rare.
From 1995 to 2011, 14 patients with non-small cell lung cancer who were also receiving hemodialysis underwent lung resection by open thoracotomy or VATS at our institution. These patients were divided into two groups as follows: open (five men and four women, mean age: 68.7 years) and (2) VATS (three men and two women, mean age: 64.0 years). We compared the clinical outcomes of these two groups.
Lobectomy was performed in eight patients in the open group, including one patient who also underwent a pneumonectomy, and in four patients in the VATS group, including one who also underwent a wedge resection. There were no significant difference between the groups' operation times, intraoperative blood loss, length of postoperative chest drainage, and length of postoperative hospitalization. There were no hospital deaths in either group. The 5-year survival rate was 42.9% in the open group and 37.5% in the VATS group. This difference was not significant (P=0.73).
VATS lung resection for lung cancer patients on hemodialysis is considered an acceptable treatment modality, though the long-term survival rate of such patients is relatively low, which can be attributed to the diseases underlying the need for hemodialysis.
近年来，血液透析患者的数量持续增加。与此同时，电视辅助胸腔镜手术（VATS）在肺癌治疗中的应用也有所增加。然而，关于血液透析患者接受VATS治疗结果的报道仍然相当少见。
1995年至2011年期间，14例同时接受血液透析的非小细胞肺癌患者在我院接受了开胸手术或VATS肺切除术。这些患者被分为以下两组：（1）开胸组（5名男性和4名女性，平均年龄：68.7岁）和（2）VATS组（3名男性和2名女性，平均年龄：64.0岁）。我们比较了这两组的临床结果。
开胸组8例患者接受了肺叶切除术，其中1例还接受了全肺切除术；VATS组4例患者接受了肺叶切除术，其中1例还接受了楔形切除术。两组在手术时间、术中出血量、术后胸腔引流时间和术后住院时间方面均无显著差异。两组均无医院死亡病例。开胸组的5年生存率为42.9%，VATS组为37.5%。这种差异无统计学意义（P = 0.73）。
对于接受血液透析的肺癌患者，VATS肺切除术被认为是一种可接受的治疗方式，尽管此类患者的长期生存率相对较低，这可能归因于需要进行血液透析的基础疾病。
