CAJ | 학술논문

目的探讨全胸腔镜肺叶切除治疗Ⅰ/Ⅱ期非小细胞肺癌( NSCLC)的安全性及近远期疗效. 方法选取临床Ⅰ/Ⅱ期NSCLC患者130例为研究对象,最后纳入研究的病例为122例,其中65例行全胸腔镜肺叶切除术( VAST组) ,56例行常规开胸肺叶切除术(开胸组). 记录对两组患者手术时间、手术出血量、淋巴结清扫数量、胸引流管放置时间、术后引流总量、术后镇痛时间、术后住院时间以及并发症发生率等指标. 评价患者手术前及手术后6个月的生活质量,统计患者1年、2年局部复发、远处转移率及生存率. 结果与开胸组相比较,VAST组患者术中出血量、胸腔引流量明显减少,术后镇痛时间、平均住院时间及淋巴结清扫时间显著缩短,术后并发症发生率降低,差异均有统计学意义(P<0.05). 术后6个月两组患者的生活质量均得到改善,但VAST组优于开胸组(P<0.05). VAST组2年局部复发率显著低于开胸组(P<0.05);2年无瘤生存率显著高于开胸组(P<0.05). 结论全胸腔镜肺叶切除术治疗Ⅰ/Ⅱ期非小细胞肺癌患者治疗效果佳,可降低术后并发症,提高对患生活质量,对改善远期疗效有一定的益处.
목적 탐토전흉강경폐협절제치료Ⅰ/Ⅱ기비소세포폐암( NSCLC)적안전성급근원기료효. 방법 선취림상Ⅰ/Ⅱ기NSCLC환자130례위연구대상,최후납입연구적병례위122례,기중65례행전흉강경폐협절제술( VAST조) ,56례행상규개흉폐협절제술(개흉조). 기록대량조환자수술시간、수술출혈량、림파결청소수량、흉인류관방치시간、술후인류총량、술후진통시간、술후주원시간이급병발증발생솔등지표. 평개환자수술전급수술후6개월적생활질량,통계환자1년、2년국부복발、원처전이솔급생존솔. 결과 여개흉조상비교,VAST조환자술중출혈량、흉강인류량명현감소,술후진통시간、평균주원시간급림파결청소시간현저축단,술후병발증발생솔강저,차이균유통계학의의(P<0.05). 술후6개월량조환자적생활질량균득도개선,단VAST조우우개흉조(P<0.05). VAST조2년국부복발솔현저저우개흉조(P<0.05);2년무류생존솔현저고우개흉조(P<0.05). 결론 전흉강경폐협절제술치료Ⅰ/Ⅱ기비소세포폐암환자치료효과가,가강저술후병발증,제고대환생활질량,대개선원기료효유일정적익처.
Objective To evaluate the safety,short-term and long-term efficacy of minimally invasive surgery for stageⅠ/Ⅱnon-small cell lung cancer ( NSCLC) .Methods 130 cases of stageⅠ/Ⅱ NSCLC were selected and 122 patients were enrolled in the study at last,including 65 cases treated with total thoracoscopic lobectomy ( VAST group) and 56 cases treated with conventional thoracotomy lobectomy (control group).Operative time,blood loss,number of lymph nodes dissection,chest drainage tube placement time,total postoperative drainage,postoperative analgesia time,the length of hospital stay and complica-tion rates of the 2 groups were recorded.Quality of life before surgery and 6 months after surgery were evaluated,and 1-year,2-year local recurrence,distant metastasis rates and survival rates of patients were analyzed.Results There had statistical differ-ence between the 2 groups in blood loss,length of postoperative analgesic time,length of hospital stay,time of lymph node dissec-tion and complications(P<0.05).Quality of life of the 2 groups in 6 months were improved,but that of the VAST group was bet-ter than that of the thoracotomy group (P<0.05).2-year local recurrence rate in the VAST group was significantly lower than that of the thoracotomy group ( P<0.05);2-year disease-free survival rate in the VAST group was significantly higher than that of the thoracotomy group (P<0.05).Conclusion The total thoracoscopic lobectomy for stageⅠ/ⅡNSCLC is effective,it can re-duce the rate of complications and improve the quality of life of patients,and it is beneficial for the improvement of long-term effi-cacy.