胸腔镜肺楔形切除术与胸腔镜肺叶切除加纵隔淋巴结清扫术治疗早期非小细胞肺癌患者的临床效果比较

目的:对比分析胸腔镜肺楔形切除术与胸腔镜肺叶切除加纵隔淋巴结清扫术治疗早期非小细胞肺癌患者的临床效果。方法:选择2012年1月～2016年12月我院心胸外科收治的70例早期非小细胞肺癌患者,将其随机分为两组。对照组采取胸腔镜肺叶切除加纵隔淋巴结清扫术治疗,观察组采取胸腔镜肺楔形切除术治疗。比较两组的手术情况、术后情况、预后情况以及生存情况。结果:观察组的术中出血量以及手术时间明显短于对照组(P0.05),术后总引流量、留置引流管时间、术后住院时间以及VAS疼痛评分均明显低于对照组(P0.05)。观察组术后1年的手术切缘转移率为0.00%(0/35),死亡率为11.43%(4/35),均明显低于对照组(P0.05)。两组的局部复发率、复发率、胸腔内转移率、淋巴结转移率、远处转移率、肿瘤相关性死亡率相比无明显的差异(P0.05)。对照组患者的无病进展生存期为8.24个月(95%CI:9.34～6.27),中位生存期为15.29个月(95%CI:12.14～21.78);观察组患者的无疾病进展生存期为11.26个月(95%CI:9.37～14.35),中位生存期为18.13个月(95%CI:15.24～22.36),均明显长于对照组(P0.05)。结论:胸腔镜肺楔形切除术治疗早期非小细胞肺癌患者的临床效果明显优于胸腔镜肺叶切除加纵隔淋巴结清扫术治疗。

Comparison of the Clinical Efficacy of Thoracoscopic Pulmonary Wedge Resection and Thoracoscopic Lobectomy Plus Mediastinal Lymphadenectomy in the Treatment of Early Non-small Cell Lung Cancer

ABSTRACT Objective: To compare the clinical effects of thoracoscopic pulmonary wedge resection and thoracoscopic lobectomy plus mediastinal lymphadenectomy in the treatment of early non-small cell lung cancer. Methods: 70 cases of patients with early non-small cell lung cancer who were treated in our hospital from January 2012 to December 2016 were selected and randomly divided into two groups. The control group was given thoracoscopic lobectomy plus mediastinal lymph node dissection, while the observation group was given thoracoscopic wedge resection. The operative and post-operative condition, prognosis and survival of the two groups were compared. Results: The bleeding volume and operation time in the observation group were significantly shorter than those in the control group (P<0.05), and the total drainage volume, indwelling drainage tube time, hospitalization time and VAS pain score in the observation group were significantly lower than those in the control group (P<0.05). No margin metastasis was found in the observation group and the mortality rate was 11.43% (4/35) in the observation group at one year after operation, which were significantly lower than those in the control group (P<0.05). There was no significant difference in the local recurrence rate, recurrence rate, intrathoracic metastasis rate, lymph node metastasis rate, distant metastasis rate and cancer-related mortality rate between the two groups (P>0.05). The disease-free progressive survival period of the control group was 8.24 months (95% CI: 9.34-6.27), the median survival period was 15.29 months (95% CI: 12.14-21.78); the disease-free progressive survival period of the observation group was 11.26 months (95% CI: 9.37-14.35), and the median survival period was 18.13 months (95% CI: 15.24-22.36), which were significantly longer than that of the control group (P<0.05). Conclusion: Thoracoscopic pulmonary wedge resection is more effective than thoracoscopic lobectomy plus mediastinal lymphadenectomy in the treatment of early non-small cell lung cancer. Video-assisted thoracoscopic pulmonary wedge resection is an effective treatment for the early non-small cell lung cancer.