CAJ | 학술논문

亚肺叶切除包括肺段切除和楔形切除,可用于部分高度选择的早期非小细胞肺癌(NSCLC).与常规肺叶切除相比,亚肺叶切除可以保留更多的健康肺功能,提高患者术后生活质量.但对于肿瘤可否切除彻底,是否会增加手术后局部复发和远处转移一直存在争议.越来越多的证据显示,对于满足以下条件的早期NSCLC采用解剖性肺段切除取得了同肺叶切除类似的治疗效果:ⅠA期;位于肺实质外1/3部位且肿瘤最大径≤2 cm;CT提示磨玻璃样影中实性成分≤50％等.目前的证据多来自于回顾性临床研究,大规模的临床前瞻性研究正在进行中.在高等级的证据出现之前,肺叶切除术仍被认为是目前早期NSCLC的标准术式.
아폐협절제포괄폐단절제화설형절제,가용우부분고도선택적조기비소세포폐암(NSCLC).여상규폐협절제상비,아폐협절제가이보류경다적건강폐공능,제고환자술후생활질량.단대우종류가부절제철저,시부회증가수술후국부복발화원처전이일직존재쟁의.월래월다적증거현시,대우만족이하조건적조기NSCLC채용해부성폐단절제취득료동폐협절제유사적치료효과:ⅠA기;위우폐실질외1/3부위차종류최대경≤2 cm;CT제시마파리양영중실성성분≤50％등.목전적증거다래자우회고성림상연구,대규모적림상전첨성연구정재진행중.재고등급적증거출현지전,폐협절제술잉피인위시목전조기NSCLC적표준술식.
Anatomic segmentectomy is alternative to lobectomy for the surgical treatment of selected patients with early stage non-small cell lung cancer.Segmentectomy can reserve more pulmonary function in such patients.Emerging evidence suggests that segmentectomy may offer survival outcomes approaching that of lobectomy for lung cancer patients whose disease meets the following criteria:stage Ⅰ A disease with no regional lymph node metastasis;tumor up to 2 cm in diameter;located in the periphery of lung;and predominantly ground-glass appearance on CT imaging.Compare with wedge resection,segmentectomy obtained the best results.Nevertheless,the evidence is currently still limited,and the above criteria are met only in a minority of patients.Large randomized trials are underway to define the clinical role of segmentectomy,and results are eagerly anticipated.Until that time,lobectomy should still be regarded as the standard therapy for patients with early stage non-small cell lung cancer.