CAJ | 학술논문

目的：探讨同期手术治疗非小细胞肺癌合并胸椎寡转移的方法和疗效。方法回顾性分析非小细胞肺癌单纯胸椎转移患者10例，同期行前路经胸肺癌联合胸椎转移病灶切除，记录手术时间、术中出血量、术后胸腔闭式引流管的拔除时间、术后并发症发生率、术后复发率和生存时间。评估手术方式对患者术前术后疼痛[视觉模拟评分（visual analogue score，VAS）]、神经功能（Frankel分级）和生活质量的改善情况。结果10例单纯胸椎转移灶切除患者的平均手术时间为（348．00±27．48）min，术中出血量（1500．00±547．72）mL，术后胸腔闭式引流的拔出时间（9．00±1．85）d，术后中位生存时间为26个月，术后患者 VAS较术前明显降低（P＜0．05），10例中有6例（60．0％）患者 Frankel分级至少降低1级。结论非小细胞肺癌胸椎寡转移患者同期行原发病灶和转移病灶联合切除可以提高患者生存质量，可能会延长患者的生存时间。
목적：탐토동기수술치료비소세포폐암합병흉추과전이적방법화료효。방법회고성분석비소세포폐암단순흉추전이환자10례，동기행전로경흉폐암연합흉추전이병조절제，기록수술시간、술중출혈량、술후흉강폐식인류관적발제시간、술후병발증발생솔、술후복발솔화생존시간。평고수술방식대환자술전술후동통[시각모의평분（visual analogue score，VAS）]、신경공능（Frankel분급）화생활질량적개선정황。결과10례단순흉추전이조절제환자적평균수술시간위（348．00±27．48）min，술중출혈량（1500．00±547．72）mL，술후흉강폐식인류적발출시간（9．00±1．85）d，술후중위생존시간위26개월，술후환자 VAS교술전명현강저（P＜0．05），10례중유6례（60．0％）환자 Frankel분급지소강저1급。결론비소세포폐암흉추과전이환자동기행원발병조화전이병조연합절제가이제고환자생존질량，가능회연장환자적생존시간。
Objective To investigate the techniques and effects of primary and metastatic lesions by simultaneous surgical treatment of non-small cell lung cancer with thoracic oligo metastases.Methods Retrospective analysis was performed on 10 non-small cell lung cancer patients with thoracic oligo metastases who were treated in our hospital.Lobectomy and vetebrectomy by simultaneous operation was performed.Intraoperative and diagnostic data, including perioperative complications,operative time,chest tube length,intraoperative bleeding and survival time were collected using retrospective chart review.The surgical outcomes were assessed according to survival status,neurological function,local recurrence,and pain before and after surgery.Results Ten patients underwent vetebrectomy and lobectomy by one-stage operation of anterior transcavitary approach,the mean operative time was (348.00±27.48)min, intraoperative bleeding (1 500.00± 547.72)mL,chest tube length (9.00± 1.85)d,and median survival time 2 6 months.Neurologic improvement by at least one Frankel grade was noted in 6 of 10 cases (60.0%).The visual analogue score of the patients were significantly reduced after operation(P<0.05).Conclusion The patients of non-small cell lung cancer with thoracic oligo metastases who underwent simultaneous surgical treatment for the primary tumor and thoracic metastatic lesions still have chances to obtain long-term survival.