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目的通过完全胸腔镜支气管袖式肺叶切除与传统开胸支气管袖式肺叶切除两种手术方式的比较,探讨全腔镜支气管袖式肺叶切除治疗中央型支气管肺癌的可行性及安全性。方法选择5年内单一手术组连续实施支气管袖式肺叶切除术治疗中央型肺癌患者共62例,其中腔镜组14例,开胸组48例。对两组手术时间,术中出血量,术后引流管留置时间,引流量,清扫淋巴结情况,术后住院天数,术后并发症等临床资料进行比较。结果全组均手术顺利,无支气管断端癌残留,无围手术期死亡。术后引流管留置时间,引流量及住院时间腔镜组均优于开胸组。手术时间、术中出血量、清扫淋巴结情况、术后并发症两组无显著差异。结论与开胸手术相比,全腔镜支气管袖式肺叶切除治疗中央型肺癌同样安全且具有创伤小术后恢复快的优势,近期疗效可靠,具有可行性。
Objective To discuss the feasibility and safety of endoscopic bronchial sleeve lobectomy in the treatment of central bronchial lung cancer by comparing the two surgical methods of complete thoracoscopic bronchial sleeve lobectomy and traditional open chest bronchial sleeve lobectomy. Methods A total of 62 patients with central lung cancer were treated by continuous operation of bronchial sleeve lobectomy in a single operation group within 5 years. Among them, 14 were endoscopic and 48 were open thoracotomy. The clinical data such as operative time, intraoperative blood loss, postoperative drainage tube indwelling time, drainage volume, lymph node dissection, postoperative hospital stay, and postoperative complications were compared. Results All the patients were operated smoothly without residual bronchial cancer and no perioperative death. Postoperative drainage tube indwelling time, drainage and length of hospital laparoscopic group were better than the thoracotomy group. Operation time, intraoperative blood loss, lymph node dissection, postoperative complications no significant difference between the two groups. Conclusions Compared with thoracotomy, endoscopic bronchial sleeve lobectomy is equally safe and has the advantage of quick recovery after trauma operation. It is reliable and feasible in the near future.