CAJ | 학술논문

目的比较胸腔镜解剖性部分肺叶切除术与胸腔镜肺叶切除术治疗pT1aN0M0周围型非小细胞肺癌的近期疗效及术后肺功能损失情况.方法对2013年1月至7月在中国医学科学院肿瘤医院胸外科接受胸腔镜解剖性肺切除后经病理证实为pT1aN0M0的周围型非小细胞肺癌191例进行回顾性分析.根据手术方式分为胸腔镜解剖性部分肺叶切除组(71例)和胸腔镜解剖性肺叶切除组(120例).采用t检验、秩和检验、x2检验和Fisher确切概率法比较两组患者术前一般资料、手术时间、术中出血量、淋巴结清扫数目、术后引流时间、术后引流量、术后住院时间、术后并发症发生率、术后2年复发转移率及术后6个月第一秒用力呼气量占预测值的百分比(FEV1％)减少情况.结果两组患者均顺利完成手术,组间手术时间、术中出血量、淋巴结清扫数目、术后引流时间、术后引流量、术后住院时间、术后并发症发生率差异均无统计学意义(P＞0.05).术后2年随访结果显示,两组患者术后2年复发转移率差异无统计学意义(1.4％比1.7％,x2=0.000,P=1.000).胸腔镜解剖性部分肺叶切除组的FEV1％减少值少于胸腔镜肺叶切除组(14％±4％比16％±4％,t=2.408,P=0.017).结论胸腔镜解剖性部分肺叶切除术应用于pT1 aN0M0周围型非小细胞肺癌,安全、有效,其短期疗效与肺叶切除术相当,其肺功能损失少于肺叶切除术.
목적 비교흉강경해부성부분폐협절제술여흉강경폐협절제술치료pT1aN0M0주위형비소세포폐암적근기료효급술후폐공능손실정황.방법 대2013년1월지7월재중국의학과학원종류의원흉외과접수흉강경해부성폐절제후경병리증실위pT1aN0M0적주위형비소세포폐암191례진행회고성분석.근거수술방식분위흉강경해부성부분폐협절제조(71례)화흉강경해부성폐협절제조(120례).채용t검험、질화검험、x2검험화Fisher학절개솔법비교량조환자술전일반자료、수술시간、술중출혈량、림파결청소수목、술후인류시간、술후인류량、술후주원시간、술후병발증발생솔、술후2년복발전이솔급술후6개월제일초용력호기량점예측치적백분비(FEV1％)감소정황.결과 량조환자균순리완성수술,조간수술시간、술중출혈량、림파결청소수목、술후인류시간、술후인류량、술후주원시간、술후병발증발생솔차이균무통계학의의(P＞0.05).술후2년수방결과현시,량조환자술후2년복발전이솔차이무통계학의의(1.4％비1.7％,x2=0.000,P=1.000).흉강경해부성부분폐협절제조적FEV1％감소치소우흉강경폐협절제조(14％±4％비16％±4％,t=2.408,P=0.017).결론 흉강경해부성부분폐협절제술응용우pT1 aN0M0주위형비소세포폐암,안전、유효,기단기료효여폐협절제술상당,기폐공능손실소우폐협절제술.
Objective To compare the short-term outcomes and pulmonary function loss between thoracoscopic anatomical partial-lobectomy and thoracoscopic lobectomy on the patients with pTlaN0M0 peripheral non-small cell lung cancer.Methods The clinical data of 191 patients with pT1aN0M0 peripheral non-small cell lung cancer received thoracoscopic anatomical pneumonectomy between January 2013 and July 2013 in Department of Thoracic Surgery,Cancer Hospital Chinese Academy of Medical Sciences was analyze retrospectively.There were 71 patients underwent thoracoscopic anatomical partiallobectomy and 120 patients underwent thoracoscopic lobectomy.Demographic features,operation time,blood loss,number of dissected lymph nodes,chest tube duration,drainage volume,postoperative hospital stay,postoperative complications,two-year progress and pulmonary function loss of FEV1％ (percentage of the predicted forced expiratory volume in 1 second)at 6 months were retrospectively reviewed and compared by t test,rank-sum test,x2 test and Fisher exact test.Results There were no significant differences in operation time,blood loss,number of dissected lymph nodes,chest tube duration,drainage volume,postoperative hospital stay,and postoperative complication rate (P ＞ 0.05).The two-year progress rate between two groups did not differ significantly either (1.4％ vs.1.7％,x2 =0.000,P =1.000).Pulmonary function loss of FEV1％ at 6 months was significantly smaller in thoracoscopic anatomical partial lobectomy group than thoracoscopic lobectomy group (14％ ±4％ vs.16％ ± 4％,t =2.408,P =0.017).Conclusions Thoracoscopic anatomical partial-lobectomy is safe and feasible for patients with pT1 aN0M0 peripheral non-small cell lung cancer.It could achieve equal short-term effect and reserve more pulmonary function compared with thoracoscopic lobectomy.