【摘要】 目的探讨电视胸腔镜辅助胸壁小切口肺癌根治术的临床效果。方法比较2003年1～6月我院36例电视胸腔镜辅助胸壁小切口行肺癌根治术(胸腔镜组)与30例常规开胸行肺癌根治术(开胸组)手术及生存情况。结果胸腔镜组手术时间(114.6±47.4)min与开胸组(123.3±43.9)min无统计学差异(t=-0.768,P=0.449);胸腔镜组住院时间(9.2±1.4)d明显短于开胸组(10.5±1.7)d(t=-3.408,P=0.001);采用log-rank检验法比较胸腔镜组与开胸组生存曲线无统计学差异(χ2=0.270,P=0.605);COX回归分析显示病理类型(相对危险度3.912,P=0.000)、pTNM分期(相对危险度3.737,P=0.000)及淋巴结转移(相对危险度15.495,P=0.000)是影响非小细胞肺癌术后生存的危险因素,选用何种手术切口与预后无关(P=0.414)。结论电视胸腔镜辅助胸壁小切口肺癌根治术安全、可靠,可取得满意疗效。更多还原

【Abstract】 Objective To evaluate the outcomes of thoracoscopy-assisted mini-incision procedure in patients with lung cancer.Methods From January 2003 to June 2003,66 patients with non-small cell lung cancer were treated in our hospital by lobectomy combined with mediastinal lymph node resection using thoracoscopy-assisted mini-incision(36 patients,VATS Group)or traditional surgery(30 patients,traditional group).The clinical and follow-up data of the two groups were compared after the operation.Results No significant difference was found in the operation time between the VATS and traditional groups(114.6±47.4)min vs(123.3±43.9)min,t=-0.768,P=0.449],while the postoperative hospital stay of the VATS group was significantly shorter than that in the traditional group (9.2±1.4)d vs(10.5±1.7)d,t=-3.408,P=0.001].Log-rank test showed that the survival curve in the two groups was comparable(χ2=0.270,P=0.605).Cox regression model indicated that the pathological characteristics(risk ratio:3.912,P=0.000),TNM stage(risk ratio:3.737,P=0.000),and lymph node metastasis(risk ratio:15.495,P=0.000)were independent,unfavorable prognostic factors for the disease;whereas,no relation was detected between the thoracotomy incision and prognosis(P=0.414).Conclusions Thoracoscopy-assisted mini-incision procedure is a safe and reliable approach for patients with lung cancer with satisfying outcomes.更多还原