肺楔形切除术与解剖性肺叶切除术治疗早期非小细胞肺癌的效果分析

摘要

Objective To observe the effect of wedge resection and anatomical lobectomy in the treatment of early non-small cell lung cancer(NSCLC).Method 92 cases of early NSCLC patients were retrospectively analyzed,these pa-tients were stratified as study group that received thoracoscopic wedge resection(n=46),or control group that was admin-istered with anatomical lobectomy.The intraoperative blood loss,operative time,postoperative hospital stay,postopera-tive local recurrence,survival rate,recurrence and complication of the two groups were statistically analyzed,and the clin-ical effect of thoracoscopic sublobectomy was evaluated.Result The intraoperative blood loss,operative time and post-operative hospital stay in the study group were significantly lower than those in the control group(P<0.01).The local re-currence rate and the incidence of complications in study group were lower than those in the control group,but the differ-ences were not statistically significant(P>0.05).Patients were followed for 9 to 36 months,and 5 deaths were observed in study group,with the cumulative survival rate being 89.1%;there were 9 deaths in control group,and the cumulative sur-vival rate was 80.4%,the 3-year cumulative survival rates demonstrated no significant difference between the two groups (χ2=1.322,P>0.05).Conclusion Thorascopic wedge resection,which can shorten the operative time and hospital stay,re-duce intraoperative blood loss with minimal surgical wound,and would neither increase the local recurrence rate nor re-duce the long-term survival rate,is a safe and effective treatment.%目的 分析胸腔镜肺楔形切除术与解剖性肺叶切除术治疗早期非小细胞肺癌(NSCLC)的效果.方法 回顾性分析92例早期NSCLC患者的临床资料,根据不同的治疗方法分为观察组46例(胸腔镜肺楔形切除术)和对照组46例(解剖性肺叶切除术).分析两组患者的术中出血量、手术时间、术后住院时间、术后局部复发情况、生存率情况、复发及并发症的发生情况,评价胸腔镜亚肺叶切除术的治疗效果.结果 观察组患者的术中出血量、手术时间和术后住院时间均明显低于对照组,差异均有统计学意义(P﹤0.01).观察组患者的局部复发率和并发症发生率均低于对照组,但差异均无统计学意义(P﹥0.05).随访时间为9~36个月,观察组患者中5例死亡,累积生存率为89.1%;对照组患者中9例死亡,累积生存率为80.4%,两组患者的3年累积生存率比较,差异无统计学意义(χ2=1.322,P﹥0.05).结论 胸腔镜肺楔形切除术可以缩短患者的手术时间和住院时间,减少术中出血量,减轻机体创伤,同时未增加局部复发率,未降低远期生存率,是一种安全、有效的治疗方式.