作　　者： (庞文广）; (黄凤柳）; (叶敏）; (庞景灼）; (伍硕允）;

机构地区： 江门市中心医院胸外科,广东江门529030

出　　处： 《临床肺科杂志》 2017年第10期1874-1878,1883,共6页

摘　　要： 目的前瞻性对比研究完全胸腔镜下解剖性肺段切除术与肺叶切除术治疗早期肺癌的临床效果,评估全腔镜解剖性肺段切除术在早期肺癌的应用价值。方法将肺部小结节(CT上直径≤2cm)患者随机分入全腔镜解剖性肺段切除术组及肺叶切除术组。比较其手术并发症、术后肺功能及手术短期效果。结果两组分别入组35例。无中转开胸,无围术期死亡,解剖性肺段切除组手术时间长于肺叶切除组(P<0.05),但解剖性肺段切除术组术后住院时间少于肺叶切除术组(P<0.05)。两组术中出血量、清扫淋巴结个数、术后引流时间、术后并发症发生率、术后1年生存率及复发率比较均无明显差异(P>0.05)。两组患者术后1年用力肺活量(FVC)、第1秒钟用力呼气量与用力肺活量比值(FEV1%)及最大通气量(MVV)均较术前下降,但解剖性肺段除组术后下降比例较小(P<0.05)。结论完全胸腔镜下解剖性肺段切除术与肺叶切除术治疗早期肺癌并发症相似,短期疗效无明显差异,但解剖性肺段切除术对于患者肺功能的保护更为好,可能对提高患者术后生活质量有帮助。 Objective To prospectively compare clinical efficacy of total thoracoscopic segmentectomy and lobectomy in treatment of early stage lung cancer, in order to evaluate the application of totally thoracoscopic segmen-tectomy in early stage lung cancer. Methods Patient with pulmonary nodules （ CT diameter 2 cm） were randomly divided into the total thoracoscopic segmentectomy group and the lobectomy group. Their surgical complications, post-operative lung function and short-term operation effect were compared. Results 35 patients were successfully joined into two groups respectively. No conversion to thomcoctomy and no perioperative mortality occurred. Compared to to-tally thoracoscopic lobectomy, the operative time was longer （ P 〈 0. 05 ） and the postoperative hospitalization time was lesser （P 〈0. 05） in totally thoracoscopic segmentectomy. The intraoperative bleeding, number of the resected lymph nodes, postoperative drainage time, perioperative complications morbidity, 1-year postoperative survival and recurrence rate had no statistical discrepancy （ P 〉 0. 05 ） . The decrement rate of pulmonary function was much better in total thoracoscopic segmentectomy （P 〈 0. 05 ） . Conclusion In early stage lung cancer, the complications and short-term effect between total thoracoscopic segmentectomy and lobectomy are similar. It is better for protecting pul-monary function in segmentectomy and could improve the quality of life of patients after operation.

关 键 词： 全胸腔镜 解剖性肺段切除术 肺叶切除术 早期肺癌 前瞻性研究 微创