老年患者在传统开胸与胸腔镜下手术切除周围型肺癌疗效的比较研究

目的:对比分析传统开胸手术和胸腔镜下肺叶切除对老年性早期周围型肺癌的疗效及生存曲线的差异。方法:选取我院行肺癌手术治疗的患者65例,均为周围型肺癌。采用非随机对照方法,将患者随机分为传统开胸手术组和胸腔镜组,其中开胸手术组34例,胸腔镜组31例。按照既定分组方案实施手术,对比分析两组患者一般属性资料、手术相关指标;术后随访至2016年6月,采用Kaplan-Meier法对比2组患者5年总生存率(OS)、无复发生存率(RFS)。结果:胸腔镜手术组手术时间明显长于开胸组(p0.05)。胸腔镜组拔出胸腔引流管天数明显缩短(p0.05)。胸腔镜组术中出血量少于开胸组(p0.05)。胸腔镜组术后并发症发生率、VAS评分、住院时间低于开胸组(p0.05)。但胸腔镜组住院总费用多于开胸组(p0.05)。开胸组组5年RFS为65.27%,胸腔镜组67.13%,差异无统计学意义(p0.05)。开胸组患者5年OS为53.73%,胸腔镜组为55.34%,差异有统计学意义(p0.05)。结论:相比传统开胸手术,胸腔镜下早期肺癌切除术出血量少,恢复快,术后并发症发生率低,术后5年总生存率高于传统开胸术。

Comparative Study of Resection by Traditonal Thoracotomy and the Thoracoscope for Senile Patients with Lung Cancer

ABSTRACT Objective: To analyze the curative effects of resection by traditional thoracotomy and thoracoscopy for senile peripheral lung cancer. Methods: 65 patients with peripheral lung cancer were randomly divided into traditional thoracotomy surgical group and thoracoscope group. Operation protocol are in accordance with established grouping scheme, compare two groups of patients with general attribute data, indicators related to the operation. Postoperative follow-up last to June 2016, Kaplan Meier-method is used to evaluate patients'' 5-year overall survival (OS) and relapse-free survival (RFS). Results: The thoracoscope surgery group operating time significantly longer than thoracotomy group (p<0.05). The time of intrathoracic drain in thoracoscope group was obviously shortened (p<0.05). The loss of blood in thoracoscope group is less than thoracotomy group (p<0.05). Postoperative complications such as VAS score decreased, and the hospitalization time is shorter than thoracotomy group (p<0.05). But the thoracoscope hospitalization expenditure is more expensive than thoracotomy group (p< 0.05). RFS of thoracotomy group for five years was 65.27%, and the thoracoscope group was 67.13%; there was no statistically significant difference (p>0.05). Thoracotomy patients OS for 5 years was 53.73%, the thoracoscope group was 55.34%, the difference was statistically significant (p<0.05). Conclusion: Compared with the traditional thoracotomy surgery, blood loss,is more than lung cancer resection under thoracoscope. Thoracoscope make the patient recover faster.