论文部分内容阅读
目的探讨模块化清扫法在单孔胸腔镜肺癌根治术中对纵隔淋巴结清扫的效果,评估其安全性与可行性。方法回顾性分析我科2015年3~12月间行胸腔镜肺癌根治术的311例非小细胞肺癌患者的临床资料,其中男171例、女140例,平均年龄(59.4±5.1)岁。单孔手术(单孔组)208例,男110例、女98例,平均年龄(59.2±5.3)岁;三孔手术(三孔组)103例,男61例、女42例,平均年龄(59.7±5.1)岁。所有患者进行模块化纵隔淋巴结清扫。比较两组淋巴结清扫情况(尤其N2站淋巴结清扫效果)与术后临床资料。结果两组均无围术期死亡病例。单孔组人均清扫淋巴结(7.3±1.0)组,共(17.5±3.0)枚,其中N2站淋巴结(4.3±0.7)组,共(8.6±1.1)枚,三孔组人均清扫淋巴结(7.2±1.0)组,共(17.7±2.7)枚,其中N2站淋巴结(4.3±0.6)组,共(8.5±1.1)枚,两组间差异均无统计学意义(P>0.05)。两种术式对左、右两侧N2站各组淋巴结的清扫率及清扫枚数差异无统计学意义(P>0.05)。单孔组术后胸腔引流时间和住院时间分别为(4.4±1.3)d和(9.2±0.9)d,均较三孔组[(5.0±1.3)d,(9.8±2.0)d]显著缩短(P<0.001),两组术后并发症发生率差异无统计学意义(P>0.05)。结论纵隔淋巴结模块化清扫能够达到肺癌根治对淋巴结的清扫要求,可安全、有效地用于单孔胸腔镜肺癌根治术。
Objective To investigate the effect of modular dissection on mediastinal lymph node dissection in radical mastectomy for lung cancer and to evaluate its safety and feasibility. Methods The clinical data of 311 patients with non-small cell lung cancer undergoing thoracoscopic lung cancer radical resection from March 2015 to December 2015 in our department were retrospectively analyzed. There were 171 males and 140 females, with an average age of 59.4 ± 5.1 years. One-hole surgery (single hole group) 208 cases, 110 males and 98 females, mean age (59.2 ± 5.3) years; 103 cases of three-hole surgery 59.7 ± 5.1) years old. All patients underwent modular mediastinal lymph node dissection. Lymph node dissection between the two groups (especially lymph node dissection in N2 station) and postoperative clinical data were compared. Results There were no perioperative deaths in both groups. (7.3 ± 1.0) in the single-hole group (17.5 ± 3.0), among which, there were (4.3 ± 0.7) in the N2 group, (8.6 ± 1.1) in the N2 group and 7.2 ± 1.0 ) Group (17.7 ± 2.7). There were no significant differences between the two groups (P> 0.05). There was no significant difference between the two types of lymph node clearance rate and the number of lymph nodes in N2 stations on the left and right sides (P> 0.05). The postoperative chest drainage time and hospital stay in the single-hole group were (4.4 ± 1.3) days and (9.2 ± 0.9) days, respectively, which were significantly shorter than those in the three-hole group [(5.0 ± 1.3) days and (9.8 ± 2.0 days) P <0.001). There was no significant difference in the incidence of postoperative complications between the two groups (P> 0.05). Conclusion Modular dissection of mediastinal lymph nodes can achieve the requirement of lymph node dissection for radical resection of lung cancer, and can be safely and effectively used for the single-hole thoracoscopic lung cancer radical operation.