【摘要】 目的探究电视胸腔镜微创手术(VATS)与常规开胸手术(TOS)淋巴结清扫治疗非小细胞肺癌(NSCLC疗效及对术后复发和预后的影响。方法回顾性收集82例NSCLC患者,按手术方法分为观察组(VATS,40例)与对照组(TOS,42例)。所有患者均行系统性淋巴结清扫。比较2组手术疗效指标、清扫淋巴结站数、数目、淋巴结总数及病理检测阳性的淋巴结数目,并统计术后并发症发生率。术后随访3年,统计2组术后复发和预后生存率。结果 2组手术时间比较无显著差异(P> 0.05);观察组术中出血量及术后胸腔引流量显著少于对照组,术后拔胸引管时间及住院时间显著短于对照组(P <0.05); 2组淋巴结清扫情况对比无显著差异(P> 0.05)。观察组并发症发生率、术后复发率低于对照组(P <0.05)、3年生存率显著高于对照组(P <0.05)。结论 VATS手术治疗NSCLC不仅可以有效减少术中出血量及术后胸腔引流量,缩短术后拔胸引管时间及住院时间,还可达到与常规TOS手术相似的淋巴结清扫效果,并降低术后复发率,延长患者术后生存期。更多还原

【Abstract】 Objective To explore the curative effect of video-assisted thoracoscopic surgery( VATS) and traditional open surgery( TOS) lymph node dissection on non-small cell lung cancer( NSCLS) and the influence on postoperative recurrence and prognosis. Methods 82 patients with NSCLS were selected and then divided into the observation group( VATS,40 cases)and the control group( TOS,42 cases) according to the surgical method. All patients underwent systematic lymph node dissection. The curative effect indexes,sites and number of removed lymph nodes,total number of lymph nodes and number of lymph nodes positive for pathological test were compared between the 2 groups. The incidence of postoperative complications was statistically analyzed. The subjects were followed up for 3 years after surgery. The postoperative recurrence rates and survival rates in both groups were statistically analyzed. Results There was no significant difference in operation time between the 2 groups( P >0. 05). The intraoperative blood loss and postoperative thoracic drainage volume of the observation group were significantly less than those of the control group. The postoperative extubation time of chest drainage tube and hospital stay were significantly shorter than the control group( P < 0. 05). There was no significant difference in lymph node dissection between the 2 groups( P >0. 05). The incidence of complications and postoperative recurrence rate in the observation group were significantly lower than those of the control group( P < 0. 05),and 3-year survival rate in the observation group were significantly higher than those of the control group( P < 0. 05). Conclusion VATS for NSCLS can not only effectively reduce intraoperative blood loss and postoperative thoracic drainage volume,shorten postoperative extubation time of chest drainage tube and hospital stay but also achieve similar lymph node dissection effect to conventional TOS,reduce postoperative recurrence rate and prolong postoperative survival.更多还原