Department of Thoracic Surgery, Shanghai Jiao Tong University, Shanghai, China.
Chin Med J (Engl). 2013 Jul;126(14):2687-93.
Although video-assisted radical operation for lung cancer has been widely accepted for treatment of nonsmall cell lung cancer (NSCLC), the debate over video-assisted thoracic surgery (VATS) segmentectomy still remains. This study analyzed the clinical outcomes using VATS segmentectomy for stage I NSCLC patients to explore the safety and efficacy of VATS segmentectomy for Ia NSCLC.
Retrospective review was conducted of patients who underwent VATS segmentectomy for clinical stage I NSCLC at Shanghai Chest Hospital between November 2009 and May 2012. VATS segmentectomy was performed on 36 patients. Analyses of the patient group were performed on patient demographics and clinical characteristics, intraoperative parameters, complications, and postoperative survival.
Thirty-five of thirty-six patients underwent VATS segmentectomy with only one conversion to open thoracic surgery. There was one peri-operative mortality from the segmentectomy group and all other patients are alive with a median follow up of 327 days. The mean volume of chest tube drainage after operation for segmentectomy was 1021.4 ml. Among other parameters, the mean blood loss was 162.5 ml (50.0 - 1600.0 ml), the mean operation time 124.8 minutes (75.0 - 271.0 minutes), chest tube duration 4.1 days (2 - 8 days), and the mean length of hospital stay 6.2 days (4 - 11 days). There was one (2.8%) locoregional recurrence after segmentectomy. Two patients successfully underwent bilateral segmentectomies and are still disease free.
For patients with stage I NSCLC, VATS segmentectomy offers a safe and equally effective option and can be applied to complicated operations such as bilateral segmentectomy.
尽管电视辅助开胸手术（video-assisted thoracic surgery，VATS）已经被广泛应用于非小细胞肺癌（non-small cell lung cancer，NSCLC）的治疗，但对于 VATS 肺段切除术仍存在争议。本研究分析了采用 VATS 肺段切除术治疗Ⅰ期 NSCLC 患者的临床结局，旨在探讨 VATS 肺段切除术治疗Ⅰa 期 NSCLC 的安全性和有效性。
回顾性分析 2009 年 11 月至 2012 年 5 月在上海胸科医院接受 VATS 肺段切除术治疗的Ⅰ期 NSCLC 患者。对 36 例患者进行 VATS 肺段切除术，分析患者的人口统计学和临床特征、术中参数、并发症和术后生存情况。
36 例患者中有 35 例成功实施了 VATS 肺段切除术，仅 1 例中转开胸手术。肺段切除术组有 1 例围手术期死亡，所有患者均存活，中位随访时间为 327 天。肺段切除术患者术后胸腔引流管引流量平均为 1021.4ml。其他参数中，平均出血量为 162.5ml（50.0-1600.0ml），平均手术时间 124.8 分钟（75.0-271.0 分钟），胸腔引流管留置时间 4.1 天（2-8 天），平均住院时间 6.2 天（4-11 天）。肺段切除术后有 1 例（2.8%）局部区域复发。2 例患者成功接受了双侧肺段切除术，目前仍无疾病复发。
对于Ⅰ期 NSCLC 患者，VATS 肺段切除术是一种安全且同样有效的治疗选择，可应用于双侧肺段切除术等复杂手术。
