CAJ | 학술논문

目的探讨电视胸腔镜手术(VATS)相对于传统开胸手术在非小细胞肺癌(NSCLC)诊断和治疗中的优势.方法收集2008年11月至2010年11月行全胸腔镜肺叶切除术患者83例,并与同期97例行传统开胸肺叶切除术的患者进行比较,术前患者均行胸部CT等常规检查临床诊断为NSCLC,观察两组患者的术中出血量、手术时间、淋巴结清扫数目、术后胸腔闭式引流天数、术后住院时间,并将数据输入SPSS17.0统计软件包,计算两组均数±标准差(x±s),统计方法采用两样本均数t检验,P≤0.05为差异有统计学意义.结果 VATS组在平均术中出血量、淋巴结清扫数目、术后胸腔闭式引流天数方面与传统开胸组比较无统计学差异,而平均手术时间多于传统开胸组,术后平均住院时间少于传统开胸组,差异具有统计学意义.结论 VATS在与传统开胸手术治疗NSCLC相比,其能达到相似的手术效果,并能明显减少术后并发症及术后住院时间,将手术创伤降至最低,提高患者术后生存质量.虽然有关VATS与传统手术术后生存效果的比较有待多中心、长期大宗完整病例的观察和分析.但有理由相信VATS应用前景将会更加广阔.
목적 탐토전시흉강경수술(VATS)상대우전통개흉수술재비소세포폐암(NSCLC)진단화치료중적우세.방법 수집2008년11월지2010년11월행전흉강경폐협절제술환자83례,병여동기97례행전통개흉폐협절제술적환자진행비교,술전환자균행흉부CT등상규검사림상진단위NSCLC,관찰량조환자적술중출혈량、수술시간、림파결청소수목、술후흉강폐식인류천수、술후주원시간,병장수거수입SPSS17.0통계연건포,계산량조균수±표준차(x±s),통계방법채용량양본균수t검험,P≤0.05위차이유통계학의의.결과 VATS조재평균술중출혈량、림파결청소수목、술후흉강폐식인류천수방면여전통개흉조비교무통계학차이,이평균수술시간다우전통개흉조,술후평균주원시간소우전통개흉조,차이구유통계학의의.결론 VATS재여전통개흉수술치료NSCLC상비,기능체도상사적수술효과,병능명현감소술후병발증급술후주원시간,장수술창상강지최저,제고환자술후생존질량.수연유관VATS여전통수술술후생존효과적비교유대다중심、장기대종완정병례적관찰화분석.단유이유상신VATS응용전경장회경가엄활.
Objective To investigate the advantages of video-assisted thoracoscopic surgery(VATS) compared with conventional thoracotomy in the diagnosis and treatment of non-small cell lung cancer (NSCLC). Methods From Nov. 2008 to Nov. 2010, 180 NSCLC patients were collected, 83 patients underwent VATS, 97 patients underwent conventional thoracotomy lobectomy. All the patients underwent preoperative chest CT checking for clinical diagnosis of NSCLC, and were observed with blood loss of operation, operative time, number of lymph node dissected, days of postoperative chest tube drainage, postoperative hospital stay, and the data were input into SPSS17.0 statistical package, calculated the two groups mean ± standard deviation (x±s), statistical methods was two sample t test,P≤0.05 was considered statistically significant. Results In VATS group, the average blood loss of operation, number of lymph node dissected, days of postoperative chest tube drainage were no significant difference compared with conventional thoracotomy, while the average operating time was more than conventional thoracotomy group, mean postoperative hospital stay was less than conventional thoracotomy group, the difference was statistically significant. Conclusion VATS in the treatment of NSCLC achieved a similar effect compared with conventional thoracotomy and significantly reduce postoperative complications and postoperative hospital stay, minimized the surgical trauma and improved the patients quality of life. Although the comparing of long time postoperative survival effect for VATS and conventional thoracotomy needed multi-center, large long-term observation and analysis of complete cases, there were reasons to believe that VATS would be more broad used in the future.