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目的探讨电视胸腔镜肺叶切除术治疗原发性支气管肺癌的早期疗效。方法 1997年6月到2004年12月间治疗121例Ⅰ、Ⅱ期肺癌患者,其中Ⅰ期101例,右上叶切除术为34例,右中叶为13例,右下叶为17例;左上叶切除术为21例,左下叶为16例。病理分型:鳞癌24例,腺癌59例,细支气管肺泡癌10例,腺鳞混合癌7例,梭形细胞癌1例。全部使用胸腔镜器械切除的有38例。结果无术中死亡,并发症发生率15%。Ⅰ期患者的术后生存率:1年为99%(76/77),2年为96%(49/51),3年为79%(15/19),腺癌相对于其他类型肺癌在术后生存率方面差异有统计学意义(P<0.01),38例全部使用电视胸腔镜手术器械切除与63例胸腔镜辅助下小切口手术者在术后牛存率方面差异无统计学意义(P>0.05),与同期传统开胸手术相比亦如此。结论电视胸腔镜肺叶切除手术治疗早期肺癌的疗效优于传统开胸手术。
Objective To investigate the early effect of video-assisted thoracoscopic lobectomy in the treatment of primary bronchogenic carcinoma. Methods From June 1997 to December 2004, 121 patients with stage I and II lung cancer were treated, including 101 cases of stage I, 34 cases of right upper lobe resection, 13 cases of right middle lobe and 17 cases of right lower lobe. The left upper lobe The resection was performed in 21 cases and in the left lower case in 16 cases. Pathological type: squamous cell carcinoma in 24 cases, adenocarcinoma in 59 cases, bronchioalveolar carcinoma in 10 cases, adenosquamous carcinoma in 7 cases, spindle cell carcinoma in 1 case. Thirty-eight patients underwent thoracoscopic surgery. No intraoperative deaths, the incidence of complications 15%. The postoperative survival rate in stage I patients was 99% (76/77) in 1 year, 96% (49/51) in 2 years and 79% (3/19) in 3 years. The survival rate of adenocarcinomas in patients with other types of lung cancer was There were significant differences in postoperative survival rate between the two groups (P <0.01). There was no significant difference in postoperative survival rate between 38 patients undergoing video-assisted thoracoscopic surgery and 63 undergoing thoracoscopic assisted small-incision surgery P> 0.05), compared with the same period of traditional thoracotomy. Conclusions Video-assisted thoracoscopic lobectomy is superior to conventional thoracotomy in the treatment of early-stage lung cancer.