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目的:探讨全胸腔镜肺叶切除及纵隔淋巴结清扫术治疗高龄非小细胞肺癌(non-small cell lung cancer,NSCLC)的临床疗效及其安全性。方法:选择2008年3月至2012年3月在我院住院治疗的NSCLC患者共118例,分为高龄组(≥70岁)26例及非高龄组(<70岁)92例,均接受全胸腔镜肺叶切除及纵隔淋巴结清扫术,观察和比较两组患者的手术时间、术中出血量、术后出血量、术后并发症、术后住院时间、淋巴结清扫枚数及转移枚数及预后情况。结果:两组患者的手术时间、术中出血量、术后出血量、术后并发症、术后住院时间均无统计学差异(P均>0.05);高龄组1年生存率为84.62%,2年生存率为69.23%,非高龄组1年生存率为90.22%,2年生存率为79.34%。两组生存曲线比较无统计学差异(Log-rank x2=3.351,P=0.082)。结论:高龄NSCLC患者全胸腔镜肺叶切除及纵隔淋巴结清扫术可获得与非高龄患者一样良好的治疗效果,因此,该术式是治疗高龄NSCLC患者的可行方法。
Objective: To investigate the clinical efficacy and safety of total thoracoscopic lobectomy and mediastinal lymph node dissection in the treatment of advanced non-small cell lung cancer (NSCLC). Methods: A total of 118 NSCLC patients hospitalized in our hospital from March 2008 to March 2012 were selected and divided into two groups: 26 in the senior group (≥70 years) and 92 in the non-senior group (<70 years) Thoracoscopic lobectomy and mediastinal lymphadenectomy. The operation time, intraoperative blood loss, postoperative blood loss, postoperative complications, postoperative hospital stay, number of lymph node dissection, number of metastasis and prognosis were observed and compared between two groups. Results: The operation time, intraoperative blood loss, postoperative blood loss, postoperative complications and postoperative hospital stay were not significantly different between the two groups (all P> 0.05). The 1-year survival rate was 84.62% The 2-year survival rate was 69.23%. The non-elderly group had a one-year survival rate of 90.22% and a 2-year survival rate of 79.34%. There was no significant difference in survival curves between the two groups (Log-rank x2 = 3.351, P = 0.082). CONCLUSION: Thoracoscopic lobectomy and mediastinal lymph node dissection in elderly patients with NSCLC can achieve the same good therapeutic effect as non-elderly patients. Therefore, this procedure is a feasible method for the treatment of advanced NSCLC.