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目的探讨电视胸腔镜辅助小切口肺叶切除、淋巴结清扫治疗早期非小细胞肺癌的临床疗效和价值。方法回顾性分析2009年6月—2010年12月本组开展的45例全胸腔镜肺叶切除的临床资料。结果 45例患者均顺利行肺叶或全肺切除和淋巴结清扫。全组患者无支气管胸膜瘘、切口感染,术中常规支气管切端快速病理提示切缘无癌残留。本组手术时间为(122±30)min,术中出血量(200±52)ml,术后引流量100～370ml,平均125ml,术后48～72h拔除胸腔引流管,拔管后即能自行下床活动,切口疼痛轻微。术后住院时间(9.5±3.5)d。全组术后1年生存率为100%,2年生存率为94.2%,3年生存率为84.7%。结论电视胸腔镜辅助小切口行肺癌根治术安全可行,创伤小,符合肺癌手术原则,可作为早期肺癌患者的推荐治疗方式。
Objective To investigate the clinical efficacy and value of video-assisted thoracoscopic assisted small incision lobectomy and lymph node dissection in the treatment of early non-small cell lung cancer. Methods The clinical data of 45 cases of thoracoscopic lobectomy in our department from June 2009 to December 2010 were retrospectively analyzed. Results All 45 patients underwent lobectomy or pneumonectomy and lymph node dissection. All patients without bronchopleural fistula, incision infection, intraoperative routine bronchial resection of the rapid pathology tips edge without cancer residue. The operation time was (122 ± 30) min, blood loss (200 ± 52) ml, postoperative drainage 100 ~ 370ml, an average of 125ml, 48 ~ 72h after surgery to remove the chest drainage tube, after extubation can self Get out of bed activity, minor incision pain. Postoperative hospital stay (9.5 ± 3.5) d. The overall 1-year survival rate was 100%, 2-year survival rate was 94.2%, 3-year survival rate was 84.7%. Conclusions The video-assisted thoracoscopic assisted small incision is safe and feasible in the treatment of lung cancer. The trauma is small and meets the principle of lung cancer surgery. It can be used as the recommended treatment for patients with early stage lung cancer.