全胸腔镜下肺叶切除治疗早期非小细胞肺癌

摘要

Objective To investigated the safty and feasibility of the completely thoracoscopic lobectomy in early stage non-small-cell lung cancer. Methods Between November 2006 and November 2007, 44 patients with NSCLC underwent completely tho-racoscopic lobectomy. The procedure were as same as compared with conventional open lobectomy. Results All procedures were car-ried out safely. Postoperative pathological results included adenocacinoma in 30 patients, squimaous carcinoma in 10, BAC in 3 andsaecomatoid carcinoma in 1. There were no operative death or serious complications and there was one conversion to open thoracotomy.All patients were well during the period of follow-up except one patient with adenocarcinoma developed metastasis of tumor 3 monthsafter operatic. Conclusion The completely thoracoscopic lobectomy is a safe and feasible surgical procedure compared with conven-tional open lobectomy.%目的 探讨全胸腔镜下肺叶切除在早期非小细胞肺癌治疗中的安全性、有效性及适应证.方法 2006年11月至2007年11月共施行全胸腔镜下肺叶切除治疗早期非小细胞肺癌44例,其中男2,4例,女20例;平均年龄61.5岁.手术全部通过3个胸腔镜切口完成,肺叶解剖性切除和系统性淋巴结清扫的操作顺序与常规开胸手术基本相同.结果 全部手术顺利,未发生严重并发症及围手术期死亡,中转开胸1例.平均手术202.6 min,平均出血216.8 ml,无输血病例.术后平均带胸管7.4 d.术后病理:腺癌30例,鳞癌10例,肺泡细胞癌3例,肉瘤样癌1例.随访平均7.7个月,1例Ⅲa期腺癌病人术后3个月发生转移,其余无复发.结论 全胸腔镜下肺叶切除在有效性、彻底性方面可以达到开胸手术相同的效果,对于早期非小细胞肺癌是一种安全、有效的手术方式.