[1]蒋伟,奚俊杰,王群,等.全胸腔镜肺癌根治术淋巴结清扫的探讨[J].中国微创外科杂志,2012,12(11):969-975.
　Jiang Wei,Xi Junjie,Wang Qun,et al.Complete Videoassisted Thoracoscopic Surgery versus Open Mediastinal Lymphadenectomy for Nonsmall Cell Lung Cancer[J].Chinese Journal of Minimally Invasive Surgery,2012,12(11):969-975.
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全胸腔镜肺癌根治术淋巴结清扫的探讨()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
12
期数:
2012年11期
页码:
969-975
栏目:
出版日期:
2012-11-20

文章信息/Info

Title:
Complete Videoassisted Thoracoscopic Surgery versus Open Mediastinal Lymphadenectomy for Nonsmall Cell Lung Cancer
作者:
蒋伟; 奚俊杰; 王群; 汪灏; 葛棣; 谭黎杰; 范虹; 徐松涛; 徐正浪
复旦大学附属中山医院胸外科，上海200032
Author(s):
Jiang Wei;  Xi Junjie;  Wang Qun;  et al
Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
关键词:
胸腔镜; 非小细胞肺癌; 肺叶切除术; 淋巴结清扫
Keywords:
Videoassisted thoracoscopic surgery; Nonsmall cell lung cancer; Lobectomy; Lymph node dissection
分类号:
R734.2
文献标志码:
A
摘要:
目的 探讨全胸腔镜下肺叶切除治疗临床Ⅰ期非小细胞肺癌淋巴结清扫的安全性和可行性。方法 2006年1月～2008年12月，160例临床Ⅰ期非小细胞肺癌接受全腔镜下肺叶切除术、纵隔淋巴结清扫，采用不撑开肋骨三孔法，并与同期247例接受常规开放手术的Ⅰ期非小细胞肺癌进行比较。结果 胸腔镜组淋巴结清扫组数（2.4±1.5）组与开胸组（2.6±1.6）组无显著差异（t=1.262，P=0.208），胸腔镜组清扫淋巴结（9.8±6.2）枚，与开胸组（9.9±5.9）枚无统计学差异（t=-0.160，P=0.873）。开胸组并发症发生率11.7%(29/247）和围手术期死亡率2.8%(7/247）与胸腔镜组并发症发生率9.4%(15/160）和围手术期死亡率0.6%(1/160）无显著差异（χ2=0.564，P=0.453； χ2=1.446，P=0.229）。胸腔镜组生存情况优于开胸组（χ2=5.373，P=0.020）。结论 全胸腔镜肺叶切除术治疗临床Ⅰ期非小细胞肺癌在技术上是安全可行的，其淋巴结清扫可达到开放手术的范围，远期疗效不亚于开放手术。
Abstract:
ObjectiveTo evaluate the safety and feasibility of videoassisted thoracoscopic surgery (VATS) for lobectomy in patients with stage Ⅰ nonsmall cell lung cancer. MethodsWe retrospectively analyzed the clinical data of 160 patients with stage Ⅰ nonsmall cell lung cancer, who underwent VATS for lobectomy and mediastinal lymphadenectomy in our hospital, from January 2006 to December 2008. Another 247 patients with stage Ⅰ nonsmall cell lung cancer, who underwent open surgery during the same period, were set as a control group.ResultsNo significant difference existed between the VATS and control groups in the numbers of removed lymph node groups and lymph nodes ［2.4±1.5 and 9.8±6.2 vs. 2.6±1.6 and 9.9±5.9; t=1262, P=0208 and t=-0.160, P=0.873, respectively］, or the rates of complications and perioperative mortality ［9.4% (15/160) and 06% (1/160) vs. 11.7% (29/247) and 2.8% (7/247), χ2=0.564, P=0.453 and χ2=1.446, P=0.229, respectively］. However, the VATS group had a higher survival rate than the control group (χ2=5.373, P=0.020). ConclusionsVATS is safe and feasible for lobectomy and mediastinal lymphadenectomy in patients with stage Ⅰ nonsmall cell lung cancer, and is effective as open surgery in the scope of lymphadenectomy. Its longterm efficacy is as good as open surgery.

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备注/Memo

备注/Memo:
王群通讯作者，Email：wang.qun@zshospital.sh.cn
更新日期/Last Update: 2013-03-27