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肺癌胸腔镜肺叶切除术的临床应用分析

Analysis of clinical application of thoracoscopic lobectomy for lung cancer.

作者信息

Luo Qing-Quan, Lin Hao, Tan Qiang, Huang Jia, Xu Lin

机构信息

Department of Thoracic Surgery, Nanjing Medical University Affiliated Cancer Hospital, No,42 Bai zi ting Road, Jiangsu 210009 Nanjing, China.

出版信息

World J Surg Oncol. 2014 May 21;12:157. doi: 10.1186/1477-7819-12-157.

Abstract

BACKGROUND

VATS has been extensively considered as a standard method of pulmonary diagnosis and treatment of benign lung diseases. This study aimed to investigate the safety, efficacy, and feasibility of video-assisted thoracoscopic surgery (VATS) lobectomy compared with conventional lobectomy via open thoracotomy in patients with clinical early stage lung cancer.

METHODS

A total of 120 patients with lung cancer underwent VATS lobectomy; another 120 patients with lung cancer underwent conventional lobectomy. The clinical outcomes from these two groups were retrospectively analyzed and compared.

RESULTS

The numbers of patients who underwent lobectomy in the left upper lobe, left lower lobe, right upper lobe, right middle lobe, and right lower lobe were 24, 28, 40, 4, and 24 in the VATS group and 38, 20, 30, 7, and 25 in the conventional group, respectively. No statistical differences were observed between the two groups. Likewise, no statistical differences were observed in terms of duration of operation, time for postoperative extubation, complications, length of hospital stay, and number of dissected lymph nodes (VATS group: left, 5.12 ± 1.45, right, 6.84 ± 1.33; conventional group: left, 4.96 ± 1.39 mm, right, 6.91 ± 1.27; P >0.05).

CONCLUSION

Anatomical lobectomy was successfully completed by VATS lobectomy for lung cancer; the standard lymph node dissection was also achieved. This procedure also showed advantages in terms of surgical bleeding, duration, postoperative complications, indwelling time of chest tube, and short-term recurrence rate without significant differences from conventional lobectomy.

摘要

背景

电视辅助胸腔镜手术(VATS)已被广泛视为良性肺部疾病的标准诊断和治疗方法。本研究旨在探讨临床早期肺癌患者行电视辅助胸腔镜手术(VATS)肺叶切除术与传统开胸肺叶切除术相比的安全性、有效性和可行性。

方法

共有120例肺癌患者接受了VATS肺叶切除术;另外120例肺癌患者接受了传统肺叶切除术。对这两组患者的临床结果进行回顾性分析和比较。

结果

VATS组左上叶、左下叶、右上叶、右中叶和右下叶行肺叶切除术的患者数量分别为24例、28例、40例、4例和24例,传统组分别为38例、20例、30例、7例和25例。两组之间未观察到统计学差异。同样,在手术时间、术后拔管时间、并发症、住院时间和清扫淋巴结数量方面也未观察到统计学差异(VATS组:左侧,5.12±1.45,右侧,6.84±1.33;传统组:左侧,4.96±1.39,右侧,6.91±1.27;P>0.05)。

结论

VATS肺叶切除术成功完成了肺癌的解剖性肺叶切除;也实现了标准的淋巴结清扫。该手术在手术出血、手术时间、术后并发症、胸管留置时间和短期复发率方面也显示出优势,与传统肺叶切除术无显著差异。

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