CAJ | 학술논문

目的：探讨非小细胞肺癌患者接受胸腔镜根治术（video-assisted thoracoscopic surgery，VATS）和传统腋下小切口根治术（minimal incision thoracotomy，MIT）的近期及远期疗效。方法选取2010年1月－2012年1月新疆医科大学附属肿瘤医院胸外科初治的病理分期 I 期（UICC2009版）的未接受术后辅助化疗的 NSCLC患者，VATS 手术75例，MIT 手术74例，比较两组在术后恢复相关指标、术后并发症、淋巴结清扫数目以及术后1、2、3年无瘤生存率的差异。结果VATS 组在术中出血量、重症监护时间、首次下床站立时间、平均住院天数均明显少于 MIT 组（P ＜0．05）。VATS 组术后全身炎性反应明显轻于 MIT 组（P ＜0．05）。VATS 组1、2、3年无瘤生存期分别为84．3％、68．6％和63．8％，MIT 组1、2、3年无瘤生存期分别为72．3％、67．7％和63．1％，差异无统计学意义（P ＝0．288）。结论胸腔镜手术对于早期非小细胞肺癌患者在术后恢复方面存在明显优势，远期疗效与传统开胸手术效果相当。
목적：탐토비소세포폐암환자접수흉강경근치술（video-assisted thoracoscopic surgery，VATS）화전통액하소절구근치술（minimal incision thoracotomy，MIT）적근기급원기료효。방법선취2010년1월－2012년1월신강의과대학부속종류의원흉외과초치적병리분기 I 기（UICC2009판）적미접수술후보조화료적 NSCLC환자，VATS 수술75례，MIT 수술74례，비교량조재술후회복상관지표、술후병발증、림파결청소수목이급술후1、2、3년무류생존솔적차이。결과VATS 조재술중출혈량、중증감호시간、수차하상참립시간、평균주원천수균명현소우 MIT 조（P ＜0．05）。VATS 조술후전신염성반응명현경우 MIT 조（P ＜0．05）。VATS 조1、2、3년무류생존기분별위84．3％、68．6％화63．8％，MIT 조1、2、3년무류생존기분별위72．3％、67．7％화63．1％，차이무통계학의의（P ＝0．288）。결론흉강경수술대우조기비소세포폐암환자재술후회복방면존재명현우세，원기료효여전통개흉수술효과상당。
Objective To analyze retrospectively the short-term and long-term effects of the stage I non-small-cell lung carcinoma patients who received video-assisted thoracoscopic surgery (VATS)and minimal incision thoracotomy (MIT)from January 2010 to January 2012.Methods We selected VATS 75 cases and MIT 74 cases of initial pathological staging Ⅰ(UICC2009)patients who did not receive postoperative adjuvant chemotherapy,and analyzed the differences between the two groups in postoperative recovery re-lated indicators,postoperative complications,the number of lymphadenectomy and 1,2,3 year disease-free survival rate.Results VATS is less and shorter than MIT (P <0.05)in intraoperative blood loss, days of intensive care,first standing time and duration of stay in hospital.After dynamic monitoring WBC and PCT,the results showed that the systemic inflammatory reaction of VATS was slighter than that of MIT (P <0.05).The 1,2,3 year DFS rates of VATS is 84.3%,68.6 and 63.8%;while the MIT is 72.3%,67.7% and 63.1%,and there was no statistical differences between the two groups (P =0.288). Conclusion Comparing with MIT,VATS has obvious advantages in postoperation recovery for early stage of NSCLC patients,and has the similar disease-free survival rate in postoperation.