中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
1期
37-40
,共4页
王光宇%初向阳%李国%薛志强%张连斌%侯晓彬
王光宇%初嚮暘%李國%薛誌彊%張連斌%侯曉彬
왕광우%초향양%리국%설지강%장련빈%후효빈
肺肿瘤%胸外科手术,电视辅助%单操作孔%淋巴结清扫
肺腫瘤%胸外科手術,電視輔助%單操作孔%淋巴結清掃
폐종류%흉외과수술,전시보조%단조작공%림파결청소
Lung neoplasms%Thoracic surgery,video-assisted%Single utility port%Lymph node dissection
目的 探讨单操作孔电视胸腔镜肺癌根治术中区域淋巴结清扫的可行性、安全性及临床效果.方法 收集2009年1月至2013年5月解放军总医院胸外科404例早期肺癌患者病历资料并进行回顾性分析.根据采用手术方式的不同分为单操作孔组(203例)和开胸组(201例),单操作孔组采用单操作孔电视胸腔镜肺叶切除术,开胸组采用常规开放肺叶切除术.比较2组术中清扫淋巴结数、转移的阳性淋巴结数、手术时间、术中出血量、术后带胸引管时间、住院时间及术后并发症等情况.结果 单操作孔组清扫淋巴结数及淋巴结转移例数与开胸组的差异均无统计学意义(均P＞0.05).单操作孔组术中出血量少于开胸组[(119 ± 50) ml比(166±78) ml],术后带管时间和术后住院时间短于开胸组[(4.9±2.2)d比(5.5±2.7)d,(10.1±2.6)d比(12.9±3.5)d],术后并发症发生率低于开胸组[7.4％ (15/203)比13.9％(28/201)],组间差异均有统计学意义(均P＜0.05).2组手术时间差异无统计学意义(P＞0.05).结论 单操作孔电视胸腔镜与常规开胸手术治疗早期非小细胞肺癌相比,具有安全、可靠、创伤小、恢复快等优势,而其淋巴结清扫范围及效果与传统开放手术相似.
目的 探討單操作孔電視胸腔鏡肺癌根治術中區域淋巴結清掃的可行性、安全性及臨床效果.方法 收集2009年1月至2013年5月解放軍總醫院胸外科404例早期肺癌患者病歷資料併進行迴顧性分析.根據採用手術方式的不同分為單操作孔組(203例)和開胸組(201例),單操作孔組採用單操作孔電視胸腔鏡肺葉切除術,開胸組採用常規開放肺葉切除術.比較2組術中清掃淋巴結數、轉移的暘性淋巴結數、手術時間、術中齣血量、術後帶胸引管時間、住院時間及術後併髮癥等情況.結果 單操作孔組清掃淋巴結數及淋巴結轉移例數與開胸組的差異均無統計學意義(均P＞0.05).單操作孔組術中齣血量少于開胸組[(119 ± 50) ml比(166±78) ml],術後帶管時間和術後住院時間短于開胸組[(4.9±2.2)d比(5.5±2.7)d,(10.1±2.6)d比(12.9±3.5)d],術後併髮癥髮生率低于開胸組[7.4％ (15/203)比13.9％(28/201)],組間差異均有統計學意義(均P＜0.05).2組手術時間差異無統計學意義(P＞0.05).結論 單操作孔電視胸腔鏡與常規開胸手術治療早期非小細胞肺癌相比,具有安全、可靠、創傷小、恢複快等優勢,而其淋巴結清掃範圍及效果與傳統開放手術相似.
목적 탐토단조작공전시흉강경폐암근치술중구역림파결청소적가행성、안전성급림상효과.방법 수집2009년1월지2013년5월해방군총의원흉외과404례조기폐암환자병력자료병진행회고성분석.근거채용수술방식적불동분위단조작공조(203례)화개흉조(201례),단조작공조채용단조작공전시흉강경폐협절제술,개흉조채용상규개방폐협절제술.비교2조술중청소림파결수、전이적양성림파결수、수술시간、술중출혈량、술후대흉인관시간、주원시간급술후병발증등정황.결과 단조작공조청소림파결수급림파결전이례수여개흉조적차이균무통계학의의(균P＞0.05).단조작공조술중출혈량소우개흉조[(119 ± 50) ml비(166±78) ml],술후대관시간화술후주원시간단우개흉조[(4.9±2.2)d비(5.5±2.7)d,(10.1±2.6)d비(12.9±3.5)d],술후병발증발생솔저우개흉조[7.4％ (15/203)비13.9％(28/201)],조간차이균유통계학의의(균P＜0.05).2조수술시간차이무통계학의의(P＞0.05).결론 단조작공전시흉강경여상규개흉수술치료조기비소세포폐암상비,구유안전、가고、창상소、회복쾌등우세,이기림파결청소범위급효과여전통개방수술상사.
Objective To evaluate the safety and clinical outcomes of single utility port complete videoassisted thoracoscopic surgery (VATS)lobectomy.Methods We retrospectively analyzed the clinical data of 203 consecutive patients with early-stage lung cancer who underwent single utility port complete VATS lobectomy from January 2009 to May 2013 in Chinese PLA general hospital (single utility port group).201 patients with earlystage lung cancer who underwent open surgery lobectomy in the same period (open surgery group)were enrolled as a control group.The clinical outcomes including lymph node dissection number,operation time,intraoperative blood loss,chest drainage duration,hospitalization time and postoperative complications were compared between the two groups.Results There were statistical differences in the intraoperative blood loss [(119 ± 50)ml vs (166 ± 78) ml],chest drainage duration [(4.9 ± 2.2) d vs (5.5 ± 2.7) d],hospitalization time [(10.1 ± 2.6) d vs(12.9 ± 3.5) d] and incidence of serious postoperative complications [7.4％ (15/203) vs 13.9％ (28/201)] between the two groups (all P ＜ 0.05).There was no statistical difference in operation time and lymph node dissection number between the two groups(P ＞ 0.05).Conclusions Single utility port complete VATS lobectomy and lymph node dissection are safe and reliable for patients with early-stage lung cancer with less injury and better postoperative recovery,compared with open surgery.Lymphadenectomy outcome related to this therapy is as good as open surgery.
