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目的比较分析完全胸腔镜下肺叶切除和解剖性肺段切除在近、远期两种手术方法的治疗效果。方法回顾性分析河南省胸科医院2010年3月至2014年7月间接受胸腔镜手术的78例肺结节患者。其中肺叶切除57例,解剖性肺段切除21例。观察手术时间、术中出血量、术中淋巴结清扫数目、术后胸腔引流量、并发症发生率和疼痛评分、术后住院时间等。结果对比分析两组患者,行解剖性肺段切除术组相比于肺叶切除术组,术中出血量少、术后引流量少、术后平均住院时间短、术中使用钉仓数多(P均<0.05);两组手术时间、清扫淋巴结数目、住院费用无统计学差异(P>0.05);两组患者术后均未出现严重并发症、复发及死亡。结论对于IA期非小细胞肺癌,完全胸腔镜下解剖性肺段切除是一种安全、有效的手术方式。疗效与肺叶切除术相当。段切除创伤更小、恢复更快。
Objective To compare and analyze the therapeutic effects of total thoracoscopic lobectomy and anatomic segmentectomy in the proximal and distal surgical approaches. Methods A retrospective analysis of 78 cases of pulmonary nodules undergoing thoracoscopic surgery in Henan Chest Hospital from March 2010 to July 2014 was retrospectively analyzed. Among them, 57 cases were lobectomy, and 21 cases were anatomical segmentectomy. The operation time, intraoperative blood loss, number of lymph nodes dissection, postoperative chest drainage, complication rate and pain score, postoperative hospital stay and so on were observed. Results Compared two groups of patients, the anatomical segmentectomy group compared with the lobectomy group, less blood loss, less postoperative drainage, shorter average postoperative hospital stay, intraoperative use of the number of staple cartridge P <0.05). There was no significant difference in operation time, number of lymph nodes dissected and hospitalization between the two groups (P> 0.05). No serious complications, recurrence and death occurred in both groups. Conclusions For the stage IA non-small cell lung cancer, complete thoracoscopic anatomic segmentectomy is a safe and effective surgical approach. Efficacy and lobectomy surgery. Segment less trauma, faster recovery.