Holbek Bo Laksáfoss, Petersen René Horsleben, Hansen Henrik Jessen
Department of Cardiothoracic Surgery, RT-2152, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
Section for Surgical Pathophysiology, JMC-7621, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
Gen Thorac Cardiovasc Surg. 2016 Apr;64(4):203-8. doi: 10.1007/s11748-016-0633-4. Epub 2016 Feb 25.
The objective of this study was to assess the safety of video-assisted thoracoscopic surgery (VATS) completion lobectomy (CL) for non-small cell lung cancer (NSCLC) after diagnostic wedge resection by comparing with standard VATS lobectomy (SL).
Data were retrieved from an institutional database of consecutive VATS lobectomies between January 1st 2007 and December 31st 2013. Patients were grouped into CL or SL. Patient characteristics, operative data, converted procedures, complications, and mortality was compared using Pearson Chi square, Fisher's exact test, or Mann-Whitney U test.
In total 80 CL and 958 SLs were performed. There were no significant differences in median operating time, median chest drain duration or median length of stay. Median operative bleeding was 100 mL (IQR 50-238) in the CL group compared to 75 mL (IQR 25-200) in the SL group (p = 0.01). There were no differences between groups in major or minor complications. Median time from VATS wedge resection to CL was 33 days (IQR 27-41). Conversion rate was 1.3% in the CL group and 2.6% in the SL group (p = 0.72). 30-day mortality was 0 vs. 1.1 % for the CL group and the SL group accordingly (p > 0.99).
This study comparing short-term surgical outcome and complications after surgical treatment of NSCLC indicates that VATS completion lobectomy after diagnostic wedge resection seems safe when looking at a relatively short time interval between the two procedures.
本研究的目的是通过与标准电视辅助胸腔镜肺叶切除术（SL）比较，评估诊断性楔形切除术后非小细胞肺癌（NSCLC）行电视辅助胸腔镜手术（VATS）完成肺叶切除术（CL）的安全性。
数据取自2007年1月1日至2013年12月31日期间连续进行VATS肺叶切除术的机构数据库。患者分为CL组或SL组。使用Pearson卡方检验、Fisher精确检验或Mann-Whitney U检验比较患者特征、手术数据、中转手术、并发症和死亡率。
共进行了80例CL手术和958例SL手术。中位手术时间、中位胸腔引流时间或中位住院时间无显著差异。CL组中位手术出血量为100 mL（四分位间距50 - 238），而SL组为75 mL（四分位间距25 - 200）（p = 0.01）。两组在主要或次要并发症方面无差异。从VATS楔形切除到CL的中位时间为33天（四分位间距27 - 41）。CL组的中转率为1.3%，SL组为2.6%（p = 0.72）。CL组和SL组的30天死亡率分别为0和1.1%（p > 0.99）。
本研究比较了NSCLC手术治疗后的短期手术结果和并发症，表明在两次手术间隔时间相对较短的情况下，诊断性楔形切除术后行VATS完成肺叶切除术似乎是安全的。
