胸腔镜肺叶切除术治疗非小细胞肺癌的疗效分析

王伟; 李学昌; 尚立群; 宋伟安; 文峰; 李军; 刘军强; 查鹏; 岳彩迎

doi:10.3971/j.issn.1000-8578.2017.16.1229

胸腔镜肺叶切除术治疗非小细胞肺癌的疗效分析

Operative Outcomes of Video-Assisted Thoracoscopic Lobectomy for Non-small Cell Lung Cancer

摘要

摘要:
目的探讨胸腔镜肺叶切除术治疗非小细胞肺癌的安全性、可靠性及疗效。
方法回顾性分析海军总医院116例采用电视胸腔镜行肺叶切除术的Ⅰ~Ⅲa期非小细胞肺癌临床资料，其中男62例、女54例；中位年龄：（59.5±11.9）岁（范围：35~82岁）。采用Kaplan-Meier法对随访结果进行生存率统计。
结果无围术期死亡。手术时间64~276 min，出血量60~560 ml，术后住院时间5~12天。11例患者围术期发生并发症，均经对症处理恢复，平均清扫淋巴结12~31枚。随访期间共死亡11例，4例失访。116例患者5年总生存率：Ⅰ期77.6%、Ⅱ期42.4%、Ⅲa期20.8%。
结论胸腔镜肺叶切除术创伤小、疼痛轻，术后恢复快、住院时间短。生存率与开胸手术相当，已成为早中期肺癌治疗的标准术式。

Abstract:
Objective To evaluate the safety, efficacy and clinical outcomes of complete video-assisted thoracoscopic lobectomy on non-small cell lung cancer(NSCLC).
Methods We retrospectively analyzed the clinical data of 116 NSCLC patients (62 male, 54 female, median age: (59.5±11.9) years old, range: 35-82 years old) who underwent complete video-assisted thoracoscopic lobectomy in the Navy General Hospital of PLA. The survival rates from the follow-up data was analyzed and calculated by Kaplan-Meier method.
Results No perioperative mortality was observed. Operation time was 64-276 min and intraoperative blood loss was 60-560 ml. Postoperative hospital stay was 5-12days. Eleven patients had postoperative complications and were all cured by conservative treatment. Mean number of dissected lymph nodes was 12-31. A total of 11 patients were dead and four patients were lost during the follow-up. Overall 5-year survival rates were 77.6% for stageⅠ, 42.4% for stage Ⅱ and 20.8% for stage Ⅲ, respectively.
Conclusion The advantages of video-assisted thoracoscopic lobectomy include smaller surgical incision, less injury and postoperative pain, quicker postoperative recovery and shorter hospital stay. Long-term survival rate is comparable to open thoracotomy. Video-assisted thoracoscopic lobectomy can anatomically achieve complete tumor resection and systemati c lymph node dissection, and it has become a standard surgical procedure for early and middle stage NSCLC patients.

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