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分析79例早期(T1N0M0)非小细胞肺癌(NSCLC)的手术效果,其中电视胸腔镜楔形切除术21例,开胸肺叶切除术58例。比较两组间的术后并发症、病死率、复发率、生存率及肺功能等情况。结果:肿瘤的组织类型、术后并发症发生率和病死率及后期肺功能无显著性差异。胸腔镜组患者的年龄偏大,慢性阻塞性肺病(COPD)发病率高,肺功能较差;与肺叶切除组相比,胸腔镜组平均住院日明显减少,局部复发率增高,差异有统计学意义。两组的1年生存率相似(胸腔镜组95%,肺叶切除组91%),5年生存率有明显差异(胸腔镜组65%,肺叶切除组70%,P<0.05)。提示对有心肺功能损害的早期NSCLC患者,电视胸腔镜楔形切除术是一种可行的外科治疗,但由于局部复发率较高,只要患者心肺功能能耐受,仍应首选肺叶切除术。
The surgical results of 79 patients with early stage (T1N0M0) non-small cell lung cancer (NSCLC) were analyzed. Among them, 21 were video-assisted thoracoscopic wedge resection and 58 were open lobectomy. Postoperative complications, mortality, relapse rate, survival rate and pulmonary function were compared between the two groups. Results: Tumor types, postoperative complications and mortality and no significant difference in postoperative lung function. Patients in thoracoscopic group were older, chronic obstructive pulmonary disease (COPD) incidence and poor lung function; compared with lobectomy group, the average length of stay in thoracoscopic group decreased significantly, the local recurrence rate increased, the difference was statistically significant significance. The 1-year survival rates were similar between the two groups (95% for thoracoscopic and 91% for lobectomy) and 5-year survival was significantly different (65% for thoracoscopic versus 70% for lobectomy, P <0.05). Tip Video card thoracoscopic wedge resection is a viable surgical treatment of early NSCLC patients with impaired cardiopulmonary function. However, due to the high local recurrence rate, lobectomy should be the first choice as long as the cardiopulmonary function can be tolerated.