[1]武国栋,张毅**,钱坤,等.胸腔镜肺段切除术治疗60岁以上ⅠA期非小细胞肺癌的近期疗效[J].中国微创外科杂志,2017,17(1):15-18.
　Wu Guodong,Zhang Yi,Qian Kun,et al.Short-term Effect of Complete Video-assisted Thoracoscopic Anatomic Segmentectomy in Stage ⅠA Non-small Cell Lung Cancer Patients Above 60 Years Old[J].Chinese Journal of Minimally Invasive Surgery,2017,17(1):15-18.
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胸腔镜肺段切除术治疗60岁以上ⅠA期非小细胞肺癌的近期疗效()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
17
期数:
2017年1期
页码:
15-18
栏目:
临床研究
出版日期:
2017-04-18

文章信息/Info

Title:
Short-term Effect of Complete Video-assisted Thoracoscopic Anatomic Segmentectomy in Stage ⅠA Non-small Cell Lung Cancer Patients Above 60 Years Old
作者:
武国栋; 张毅**; 钱坤; 苏雷
首都医科大学宣武医院胸外科首都医科大学肺癌诊疗中心，北京100053
Author(s):
Wu Guodong;  Zhang Yi;  Qian Kun;  et al.
Department of Thoracic Surgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
关键词:
非小细胞肺癌; 电视辅助胸腔镜手术; 肺段切除术; 肺叶切除术
Keywords:
Non-small cell lung cancer; Video-assisted thoracoscopic surgery; Segmentectomy;  Lobectomy
文献标志码:
A
摘要:
目的探讨胸腔镜下肺段切除术治疗60岁以上早期非小细胞肺癌（non-small cell lung cancer,NSCLC）的近期疗效。方法回顾性分析2011年10月~2014年12月我科64例60岁以上ⅠA期NSCLC的临床资料，分别行胸腔镜下肺段切除术(肺段切除组，n=32)和胸腔镜下肺叶切除术(肺叶切除组，n=32)，比较2组手术时间、术中出血量、淋巴结清扫数目、术后引流管放置时间、住院时间、围术期并发症和随访情况。结果肺段切除组与肺叶切除组术中出血量中位数分别为100 （20~900 ml）、150（50~500 ml）ml，无统计学差异（Z=-1.509，P=0.131）；术后并发症发生率分别为6.3%（2/32）、9.4%(3/32），无统计学差异（χ2=0.000，P=1.000）；术后胸腔引流管留置时间分别为（5.4±1.2）、（5.5±1.1）d，无统计学差异（t=0.218，P=0.828）；住院时间分别为（6.4±1.2）、（6.5±1.1）d，无统计学差异（t=0.218，P=0.828）。肺段切除组手术时间（136.8±65.2）min，明显短于肺叶切除组（189.2±74.2）min（t=2.999，P=0.004）。肺段切除组淋巴结切除中位数6.5枚（3~45枚），明显少于肺叶切除组中位数12.0枚（4~30枚）（Z=-4.750，P=0.000）；肺段切除组切除N1淋巴结中位数3.0枚（2~9枚），明显少于肺叶切除组中位数5.0枚（2~11枚）（Z=-3.294，P=0.001）；切除N2淋巴结中位数3.5枚（0~36枚），明显少于肺叶切除组中位数8.5枚（1~29枚）（Z=-4.814，P=0.000）。肺段切除组32例中位随访时间18个月（12~42个月），肺叶切除组32例中位随访时间16个月（12~19个月），均无复发和转移。结论胸腔镜下肺段切除术可以作为60岁以上老年ⅠA期NSCLC的治疗选择，近期效果不差于胸腔镜肺叶切除术。
Abstract:
ObjectiveTo evaluate the short-term outcomes of video-assisted thoracoscopic surgery (VATS) of segmentectomy in the treatment of pathological stage ⅠA non-small cell lung cancer (NSCLC) in patients above sixty years old．MethodsClinical data of 64 patients with pathological stage ⅠA NSCLC who underwent VATS segmentectomy (n=32) and VATS lobectomy (n=32) from June 2011 to December 2014 in our hospital were retrospectively analyzed. The operation time, blood loss, number of dissected lymph nodes (including N1 and N2), chest tube duration, postoperative hospital stay, morbidity of postoperative complications and follow-up after operation were compared between the two groups. ResultsThere were no significant differences in blood loss ［100 (20-900) ml vs. 150 (50-500) ml, Z=-1.509, P=0.131］, morbidity of postoperative complications ［6.3%(2/32) vs. 94%(3/32), χ2=0.000, P=1.000］, chest tube duration ［(5.4±1.2) d vs. (5.5±1.1) d, t=0.218, P=0.828］, and postoperative hospital stay ［(6.4±1.2) d vs. (6.5±1.1) d, t=0.218, P=0828］ between the segmentectomy group and the lobectomy group. The operation time of VATS segmentectomy was significantly shorter than that of VATS lobectomy ［(136.8±65.2) min vs. (189.2±74.2) min, t=2.999, P=0.004］. The total number of dissected lymph nodes of VATS segmentectomy was less than that of VATS lobectomy ［6.5 (3-45) vs. 12 (4-30), Z=-4.750, P=0000］. There were significant differences in the segmentectomy group and the lobectomy group in the number of N1 lymph nodes ［3 (2-9) vs. 5 (2-11), Z=-3.294, P=0001］ and N2 lymph nodes ［3.5 (0-36) vs. 8.5 (1-29), Z=-4.814, P=0000］, respectively. There were no recurrence and metastasis during follow-ups for 12-42 months (median, 18 months) in 32 cases of segmentectomy and for 12-19 months (median, 16 months) in 32 cases of lobectomy.ConclusionsVATS segmentectomy is a choice in treatment of pathological stage ⅠA NSCLC in patients above sixty years old. The short-term outcomes are not worse than VATS lobectomy.

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备注/Memo

备注/Memo:
基金项目：北京市自然科学基金(项目编号：7132106)；北京市科委重大项目（项目编号：D141100000214002）**通讯作者，E-mail:steven9130@sina.com
更新日期/Last Update: 2017-04-18