中华胸心血管外科杂志
中華胸心血管外科雜誌
중화흉심혈관외과잡지
Chinese Journal of Thoracic and Cardiovascular Surgery
2014年
10期
611-614
,共4页
癌,非小细胞肺%淋巴结切除术
癌,非小細胞肺%淋巴結切除術
암,비소세포폐%림파결절제술
Cancer,non-small cell lung%Lymph node excision
目的 分析选择性纵隔淋巴结清扫和系统性纵隔淋巴结清扫对临床Ⅰ期非小细胞肺癌患者生存和围手术期指标的影响,以探讨前者的临床价值.方法 回顾性分析984例临床Ⅰ期非小细胞肺癌病例的临床资料,患者均接受肺叶切除术加纵隔淋巴结清扫术,其中男581例,女403例;年龄24～ 84岁,平均(59.6±10.2)岁.其中786例接受系统性纵隔淋巴结清扫,198例接受选择性纵隔淋巴结清扫.结果 选择性纵隔淋巴结清扫组的手术时间(132.3±30.3) min,系统性纵隔淋巴结清扫组的平均手术时间(150.7±41.8) min,两组差异有统计学意义(P＜0.01).选择性纵隔淋巴结清扫组平均术中出血量(96.2±53.5) ml,系统性纵隔淋巴结清扫组平均术中出血量(124.4±65.4) ml,差异有统计学意义(P＜0.01).两组生存率差异无统计学意义(P=0.844),选择性纵隔淋巴结清扫组总体复发率25.3％,系统性纵隔淋巴结清扫组总体复发率27.5％,差异无统计学意义(P=0.533).亚组分析中,两组的5年生存率差异均无统计学意义.结论 对于临床Ⅰ期非小细胞肺癌,选择性纵隔淋巴结清扫的生存不劣于系统性纵隔淋巴结清扫,且手术时间更短,术中出血量更少.
目的 分析選擇性縱隔淋巴結清掃和繫統性縱隔淋巴結清掃對臨床Ⅰ期非小細胞肺癌患者生存和圍手術期指標的影響,以探討前者的臨床價值.方法 迴顧性分析984例臨床Ⅰ期非小細胞肺癌病例的臨床資料,患者均接受肺葉切除術加縱隔淋巴結清掃術,其中男581例,女403例;年齡24～ 84歲,平均(59.6±10.2)歲.其中786例接受繫統性縱隔淋巴結清掃,198例接受選擇性縱隔淋巴結清掃.結果 選擇性縱隔淋巴結清掃組的手術時間(132.3±30.3) min,繫統性縱隔淋巴結清掃組的平均手術時間(150.7±41.8) min,兩組差異有統計學意義(P＜0.01).選擇性縱隔淋巴結清掃組平均術中齣血量(96.2±53.5) ml,繫統性縱隔淋巴結清掃組平均術中齣血量(124.4±65.4) ml,差異有統計學意義(P＜0.01).兩組生存率差異無統計學意義(P=0.844),選擇性縱隔淋巴結清掃組總體複髮率25.3％,繫統性縱隔淋巴結清掃組總體複髮率27.5％,差異無統計學意義(P=0.533).亞組分析中,兩組的5年生存率差異均無統計學意義.結論 對于臨床Ⅰ期非小細胞肺癌,選擇性縱隔淋巴結清掃的生存不劣于繫統性縱隔淋巴結清掃,且手術時間更短,術中齣血量更少.
목적 분석선택성종격림파결청소화계통성종격림파결청소대림상Ⅰ기비소세포폐암환자생존화위수술기지표적영향,이탐토전자적림상개치.방법 회고성분석984례림상Ⅰ기비소세포폐암병례적림상자료,환자균접수폐협절제술가종격림파결청소술,기중남581례,녀403례;년령24～ 84세,평균(59.6±10.2)세.기중786례접수계통성종격림파결청소,198례접수선택성종격림파결청소.결과 선택성종격림파결청소조적수술시간(132.3±30.3) min,계통성종격림파결청소조적평균수술시간(150.7±41.8) min,량조차이유통계학의의(P＜0.01).선택성종격림파결청소조평균술중출혈량(96.2±53.5) ml,계통성종격림파결청소조평균술중출혈량(124.4±65.4) ml,차이유통계학의의(P＜0.01).량조생존솔차이무통계학의의(P=0.844),선택성종격림파결청소조총체복발솔25.3％,계통성종격림파결청소조총체복발솔27.5％,차이무통계학의의(P=0.533).아조분석중,량조적5년생존솔차이균무통계학의의.결론 대우림상Ⅰ기비소세포폐암,선택성종격림파결청소적생존불렬우계통성종격림파결청소,차수술시간경단,술중출혈량경소.
Objective To analyze the survival statistics and perioperative parameters of clinical stage Ⅰ non-small cell lung cancer patients who received systemic or selective mediastinal lymphadenectomy,and explore the value of selective mediastinal lymphadenectomy for clinical stage Ⅰ non-small cell lung cancer.Methods The clinical data of 984 patients with clinical stage Ⅰ non-small cell lung cancer who underwent lobectomy and systemic/selective lymph node dissection in Zhongshan Hospital from January 2005 to December 2010 were analyzed retrospectively.There were 581 males and 403 females with an average age of(59.6 ± 10.2) (24-84) years.786 patients received systemic mediastinal lymphadenectomy,and 198 patients received selective mediastinal lymphadenectomy.Results Average operation time of selective mediastinal lymphadenectomy group was(132.3 ±30.3) minutes,and that of systemic mediastinal lymphadenectomy group was(150.7 ±41.8) minutes with significant difference(P ＜ 0.01).Average amount of intraoperative bleeding of selective mediastinal lymphadenectomy group was (96.2 ± 53.5) ml,and that of systemic mediastinal lymphadenectomy group was (124.4 ± 65.4) ml with significant difference(P ＜0.01).There was no significant difference in overall survival rate between two groups(P =0.844).Recurrence rates were 25.3 ％ and 27.5 ％,respectively (P =0.533).Subgroup analysis showed no significant difference of 5-year survival rates between the two groups.Conclusion For patients with clinical stage Ⅰ non-small cell lung cancer,selective mediastinal lymphadenectomy can reduce operation time and amount of intraoperative bleeding.Survival of patients who received selective mediastinal lymphadenectomy was no worse than that of patients who received systemic mediastinal lymphadenectomy.
