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单操作孔电视辅助胸腔镜肺叶切除术治疗老年周围型肺癌可行。

Video-assisted thoracoscopic lobectomy with a single utility port is feasible in the treatment of elderly patients with peripheral lung cancer.

机构信息

Department of Thoracic and Cardiovascular Surgery, the First Affiliated Hospital of Soochow University, Medical College of Soochow University Suzhou, China; Soochow University Laboratory of Cancer Molecular Genetics, Medical College of Soochow University Suzhou, China; Suzhou Key Laboratory for Cancer Molecular Genetics Suzhou, China.

Department of Thoracic and Cardiovascular Surgery, the First Affiliated Hospital of Soochow University, Medical College of Soochow University Suzhou, China.

出版信息

Thorac Cancer. 2014 May;5(3):219-24. doi: 10.1111/1759-7714.12081. Epub 2014 Apr 22.

Abstract

BACKGROUND

Video-assisted thoracoscopic (VATS) lobectomy with a single utility port has emerged as a new technology in recent years. The aim of this study is to review the technology in the treatment of elderly patients with peripheral lung cancer.

METHODS

We retrospectively analyzed the clinical data of 21 elderly patients with peripheral lung cancer who underwent single utility port VATS lobectomy from February 2011 to February 2013 in the First Affiliated Hospital of Soochow University (VATS group). The clinical outcomes and postoperative complications were then compared to data from 32 elderly patients who underwent lobectomy by thoracotomy (TL group).

RESULTS

No mortality occurred during the postoperative period in either group. There was no statistical difference in surgery duration, the quantity of lymph node dissection or intraoperative blood loss between the VATS and TL groups. However, significant differences existed in the postoperative hospital stay (6.19 ± 1.69 days vs. 8.22 ± 2.55 days), time to first activity out of bed (20.57 ± 7.72 hours vs. 26.81 ± 9.27 hours), chest drainage duration (4.24 ± 1.04 days vs. 5.22 ± 1.29 days), and total postoperative drainage volume (642.86 ± 158.18 mL vs. 787.81 ± 211.55 mL) between the VATS and TL groups (P <0.05). The percentage of patients with no complications in the VATS group (85.71%) is significantly higher when compared with the TL group (56.25%, P <0.05).

CONCLUSION

VATS lobectomy with a single utility port is a safe and feasible surgical procedure for selected elderly patients with peripheral lung cancer.

摘要

背景

近年来,电视辅助胸腔镜(VATS)肺叶切除术结合单操作孔技术已成为一种新的技术。本研究旨在回顾单操作孔 VATS 肺叶切除术治疗老年周围型肺癌的技术。

方法

我们回顾性分析了 2011 年 2 月至 2013 年 2 月苏州大学第一附属医院 21 例老年周围型肺癌患者行单操作孔 VATS 肺叶切除术(VATS 组)的临床资料,然后与同期 32 例行剖胸肺叶切除术(TL 组)的老年患者的临床资料进行对比。

结果

两组患者术后均无死亡。VATS 组与 TL 组在手术时间、淋巴结清扫量和术中出血量方面无统计学差异。但 VATS 组术后住院时间(6.19 ± 1.69 天比 8.22 ± 2.55 天)、首次下床活动时间(20.57 ± 7.72 小时比 26.81 ± 9.27 小时)、胸腔引流时间(4.24 ± 1.04 天比 5.22 ± 1.29 天)和术后总引流量(642.86 ± 158.18 ml 比 787.81 ± 211.55 ml)均显著低于 TL 组(P <0.05)。VATS 组无并发症患者比例(85.71%)明显高于 TL 组(56.25%,P <0.05)。

结论

单操作孔 VATS 肺叶切除术治疗老年周围型肺癌是一种安全可行的手术方法。

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Morbidity risks among older adults with pre-existing age-related diseases.老年人中患有与年龄相关的疾病的发病风险。
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Eur Respir Rev. 2013 Sep 1;22(129):382-404. doi: 10.1183/09059180.00003913.
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