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目的比较临床Ⅰ期非小细胞肺癌电视胸腔镜肺叶切除术(video-assisted thoracoscopic lobectomy,VL)与同期开胸手术中淋巴结清扫的效果。方法选取我院2008年2月～2009年5月临床Ⅰ期非小细胞肺癌69例,按患者意愿非随机分为VL组(n=43)和开胸组(n=26)。比较2组清扫淋巴结个数、清扫淋巴结组数、淋巴结转移阳性数和淋巴结清扫时间的差异。结果 2组淋巴结清扫数[(12.1±3.0)枚vs.(13.1±2.4)枚,t=-1.442,P=0.154],肺门(N1)阳性淋巴结数[(1.0±0.8)枚vs.(1.0±0.7)枚,t=0.000,P=1.000]和纵隔(N2)阳性淋巴结数[(0.1±0.2)枚vs.(0.1±0.2)枚,t=0.000,P=1.000]无显著性差异;但VL组淋巴结清扫组数少[(4.2±0.7)vs.(4.7±0.9),t=-2.578,P=0.012],清扫淋巴结时间长[(33.8±8.7)min vs.(22.6±3.9)min,t=6.186,P=0.000]。结论临床Ⅰ期非小细胞肺癌电视胸腔镜肺叶切除术中淋巴结清扫能达到开胸手术淋巴结清扫效果,但是手术时间相对较长。
Objective To compare the efficacy of video-assisted thoracoscopic lobectomy (VL) and lymph node dissection during concurrent thoracotomy in clinical stage Ⅰ non-small cell lung cancer. Methods Sixty - nine cases of clinical stage Ⅰ non - small cell lung cancer from February 2008 to May 2009 in our hospital were randomly divided into VL group (n = 43) and thoracotomy group (n = 26) according to patients’ wishes. The difference of the number of lymph nodes, the number of lymph nodes, the positive lymph nodes and lymph node dissection time were compared between the two groups. Results The number of lymph node dissection in the two groups was (12.1 ± 3.0) vs. (13.1 ± 2.4), t = -1.442, P = 0.154 and the number of positive nodes in the hilar (N1 ± [1.0 ± 0.8] vs. 1.0 ± 0.7), t = 0.000, P = 1.000], and mediastinal (N2) positive lymph nodes [(0.1 ± 0.2) pieces vs. (0.1 ± 0.2) pieces, t = 0.000, P = 1.000] ; However, the number of lymphadenectasia group in VL group was less ([4.2 ± 0.7] vs. (4.7 ± 0.9), t = -2.578, P = 0.012] ) min, t = 6.186, P = 0.000]. Conclusions Lymphadenectomy in clinical stage Ⅰ non-small cell lung cancer during video-assisted thoracoscopic lobectomy can achieve the lymphadenectomy effect of thoracotomy, but the operation time is relatively longer.