胸腔镜肺叶切除和肺段切除治疗ⅠA期非小细胞肺癌的疗效比较(1)
摘 要：目的 比较胸腔镜肺叶切除和肺段切除在ⅠA期非小细胞肺癌患者中的治疗效果。方法 回顾性分析2012年5月～2014年5月在我院行胸腔镜手术的76例ⅠA期NSCLC患者资料，按手术方式分为两组，观察组50例行肺叶切除术，对照组26例行肺段切除术。比较两组患者的手术时间、术中出血量、留置引流管时间、住院天数、并发症发生率、随访3年后复发率及死亡率。结果 观察组手术时间为(118.26±30.76)min，短于对照组的(155.51±21.91)min，差异具有统计学意义(P<0.05)。两组患者术中出血量、留置引流管时间、住院天数、并发症发生率、随访3年后复发率和死亡率比较，差异无统计学意义(P>0.05)。结论 ⅠA期NSCLC患者中肺段切除和肺叶切除治疗效果相似，而且肺段切除术能够保留更多的肺功能，有利于患者恢复。
关键词：非小细胞肺癌;肺叶切除术;肺段切除术;胸腔镜
中图分类号：R734.2 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.21.027
, 百拇医药
文章编号：1006-1959(2018)21-0100-03
Comparison of Thoracoscopic Lobectomy and Segmentectomy for ⅠA Non-small Cell Lung Cancer
XU Wen-xia，LU Hong-yan，HUANG Bin
(Department of Thoracic Surgery，Jiangyin People's Hospital Affiliated to Southeast University， Jiangyin 214400，Jiangsu，China)
Abstract：Objective To compare the therapeutic effects of thoracoscopic lobectomy and segmentectomy in patients with stage IA non-small cell lung cancer. Methods A retrospective analysis of 76 patients with stage IA NSCLC who underwent thoracoscopic surgery from May 2012 to May 2014 was divided into two groups according to the operation. 50 patients underwent lobectomy in the observation group and 26 patients in the control group underwent segmental resection. The operation time， intraoperative blood loss， indwelling drainage tube time， length of hospital stay， complication rate， recurrence rate and mortality after 3 years of follow-up were compared between the two groups. Results The operation time of the observation group was (118.26±30.76) min， which was shorter than that of the control group (155.51±21.91) min，the difference was statistically significant (P<0.05). There were no significant differences in intraoperative blood loss， indwelling drainage time， length of hospital stay， complication rate， and recurrence rate and mortality after 3 years of follow-up between the two groups (P>0.05). Conclusion The treatment of segmental resection and lobectomy in patients with stage IA NSCLC is similar，and segmentectomy can preserve more lung function and facilitate recovery.
, 百拇医药
Key words：Non-small cell lung cancer;Lobectomy;Segmentectomy;Thoracoscopic
肺癌(lung cancer)目前已成為我国发病率及死亡率最高的恶性肿瘤之一，随着外科技术及检查手段的不断进步，早期发现和微创治疗能使大多数肺癌患者得到及时有效的治疗[1，2]。近年来胸腔镜手术由于创伤小、恢复快的优点，逐渐被非小细胞肺癌(non-small cell lung cancer，NSCLC)患者接受，安全、微创等优点使其逐渐成为外科治疗早期NSCLC的标准术式。然而ⅠA期NSCLC在胸腔镜下是选择肺叶切除还是肺段切除仍然存有争议，有研究[3-5]指出对于ⅠA期NSCLC及肺良性结节进行亚肺叶(肺段和肺楔形)切除可以保留更多的肺组织，减少术后并发症，有利于术后患者恢复和生活质量的提高。本研究旨在探讨胸腔镜下肺段切除治疗ⅠA期NSCLC的安全、有效及可行性。, http://www.100md.com(徐闻霞 陆红艳 黄 斌)
关键词：非小细胞肺癌;肺叶切除术;肺段切除术;胸腔镜
中图分类号：R734.2 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.21.027
, 百拇医药
文章编号：1006-1959(2018)21-0100-03
Comparison of Thoracoscopic Lobectomy and Segmentectomy for ⅠA Non-small Cell Lung Cancer
XU Wen-xia，LU Hong-yan，HUANG Bin
(Department of Thoracic Surgery，Jiangyin People's Hospital Affiliated to Southeast University， Jiangyin 214400，Jiangsu，China)
Abstract：Objective To compare the therapeutic effects of thoracoscopic lobectomy and segmentectomy in patients with stage IA non-small cell lung cancer. Methods A retrospective analysis of 76 patients with stage IA NSCLC who underwent thoracoscopic surgery from May 2012 to May 2014 was divided into two groups according to the operation. 50 patients underwent lobectomy in the observation group and 26 patients in the control group underwent segmental resection. The operation time， intraoperative blood loss， indwelling drainage tube time， length of hospital stay， complication rate， recurrence rate and mortality after 3 years of follow-up were compared between the two groups. Results The operation time of the observation group was (118.26±30.76) min， which was shorter than that of the control group (155.51±21.91) min，the difference was statistically significant (P<0.05). There were no significant differences in intraoperative blood loss， indwelling drainage time， length of hospital stay， complication rate， and recurrence rate and mortality after 3 years of follow-up between the two groups (P>0.05). Conclusion The treatment of segmental resection and lobectomy in patients with stage IA NSCLC is similar，and segmentectomy can preserve more lung function and facilitate recovery.
, 百拇医药
Key words：Non-small cell lung cancer;Lobectomy;Segmentectomy;Thoracoscopic
肺癌(lung cancer)目前已成為我国发病率及死亡率最高的恶性肿瘤之一，随着外科技术及检查手段的不断进步，早期发现和微创治疗能使大多数肺癌患者得到及时有效的治疗[1，2]。近年来胸腔镜手术由于创伤小、恢复快的优点，逐渐被非小细胞肺癌(non-small cell lung cancer，NSCLC)患者接受，安全、微创等优点使其逐渐成为外科治疗早期NSCLC的标准术式。然而ⅠA期NSCLC在胸腔镜下是选择肺叶切除还是肺段切除仍然存有争议，有研究[3-5]指出对于ⅠA期NSCLC及肺良性结节进行亚肺叶(肺段和肺楔形)切除可以保留更多的肺组织，减少术后并发症，有利于术后患者恢复和生活质量的提高。本研究旨在探讨胸腔镜下肺段切除治疗ⅠA期NSCLC的安全、有效及可行性。, http://www.100md.com(徐闻霞 陆红艳 黄 斌)