高位单肋间两孔电视辅助胸腔镜下肺叶切除术治疗非小细胞肺癌是一种安全有效的手术方法。
Lobectomy with high-position single-intercostal two-port video-assisted thoracoscope for non-small cell lung cancer is a safe and effective surgical procedure.
作者信息
Zhao Guofang, Jiang Xu, Wang Fajiu, Chu Minghui, Zhang Chenxu, Zhao Weidi, Yang Minglei, Xu Xiang, Zheng Enkuo, Ni Junjun, Yang Liangwei
机构信息
Department of Cardiothoracic Surgery, Hwa Mei Hospital, University of Chinese Academy of Sciences (Ningbo No. 2 Hospital), Ningbo, China.
Clinical Department, Medical School of Ningbo University, Ningbo, China.
出版信息
J Thorac Dis. 2020 Dec;12(12):7346-7354. doi: 10.21037/jtd-20-3469.
BACKGROUND
High-position single-intercostal two-port video-assisted thoracic surgery (VATS) technique has been used for thoracic diseases. It can effectively avoid postoperative chronic pain compared with the traditional three-port VATS. This study aimed to evaluate the safety and efficacy of high-position single-intercostal two-port video-assisted thoracoscopic lobectomy.
METHODS
From June 2014 to December 2018, a total of 474 patients in our hospital with non-small cell lung cancer (NSCLC) underwent lobectomy with a high-position single-intercostal two-port video-assisted thoracoscope. A retrospective study of these patients was conducted, and follow-up was performed to analyze the patients' 3- and 5-year survival rates.
RESULTS
Of the total number of patients, 27.6%, 41.4%, and 31% underwent surgery between the third, fourth, and fifth intercostals, respectively. During the operation, 31 patients were converted to open surgery or three-port thoracoscopic surgery. The average surgical time was 160.9±44.9 min, the average postoperative hospital stay was 5.6±3.4 days, the incidence of postoperative complications was 7.2%, and the average number of lymph nodes resected was 13.6±5.3. The 3-year overall survival (OS) rate of IA1, IA2, IA3, IB, IIA, IIB and IIIA was 99.0%, 98.6%, 96.3%, 91.2%, 85.7%, 66.7%, and 60.8%, respectively. Meanwhile, the 5-year OS rate of IA1, IA2, IA3, IB, and IIIA was 99.0%, 94.5%, 87.5%, 85.5%, and 43.3%, respectively.
CONCLUSIONS
Lobectomy with a high-position single-intercostal two-port video-assisted thoracoscope for NSCLC is a safe and effective surgical procedure.
背景
高位单肋间两孔电视辅助胸腔镜手术（VATS）技术已用于治疗胸部疾病。与传统三孔VATS相比，它能有效避免术后慢性疼痛。本研究旨在评估高位单肋间两孔电视辅助胸腔镜肺叶切除术的安全性和有效性。
方法
2014年6月至2018年12月，我院共有474例非小细胞肺癌（NSCLC）患者接受了高位单肋间两孔电视辅助胸腔镜肺叶切除术。对这些患者进行回顾性研究，并进行随访以分析患者的3年和5年生存率。
结果
在患者总数中，分别有27.6%、41.4%和31%的患者在第三、第四和第五肋间进行了手术。手术过程中，31例患者转为开胸手术或三孔胸腔镜手术。平均手术时间为160.9±44.9分钟，平均术后住院时间为5.6±3.4天，术后并发症发生率为7.2%，平均切除淋巴结数为13.6±5.3个。IA1、IA2、IA3、IB、IIA、IIB和IIIA期的3年总生存率（OS）分别为99.0%、98.6%、96.3%、91.2%、85.7%、66.7%和60.8%。同时，IA1、IA2、IA3、IB和IIIA期的5年OS率分别为99.0%、94.5%、87.5%、85.5%和43.3%。
结论
高位单肋间两孔电视辅助胸腔镜肺叶切除术治疗NSCLC是一种安全有效的手术方法。
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