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目的评价电视胸腔镜辅助小切口肺叶切除术(VAMT)治疗早期周围型肺癌的临床应用价值。方法回顾性分析我院48例早期周围型肺癌病人的临床资料,均为非小细胞型肺癌(NSCLC),按术式分为两组。VAMT组(研究组):21例,应用VATS辅助胸壁小切口行肿物楔形切除术,术中快速病理检查证实为NSCLC,行相应的肺叶切除、系统性的肺门及纵隔淋巴结清扫术。标准开胸组(对照组):27例,采用后外侧切口进胸,其他处理与VAMT组相同。两组术后均未加辅助治疗。结果研究组术中出血量少(P<0.01),住院时间短(P<0.05),淋巴结清扫与标准开胸组比较差异无统计学意义(P>0.05)。两组均无手术死亡及严重并发症,近期随访无复发或转移。结论早期周围型肺癌采用VATS辅助小切口治疗,技术可行性高,可以替代传统的开胸切除术。
Objective To evaluate the value of video-assisted thoracoscopic assisted small incision lobectomy (VAMT) in the treatment of early peripheral lung cancer. Methods The clinical data of 48 patients with early peripheral lung cancer in our hospital were retrospectively analyzed. All of them were non-small cell lung cancer (NSCLC) and were divided into two groups according to operation method. VAMT group (study group): 21 patients underwent wedge resection with VATS assisted chest wall incision. The intraoperative rapid pathological examination confirmed NSCLC with corresponding lobectomy, systemic hilar and mediastinal lymph node dissection. Standard thoracotomy group (control group): 27 cases, posterolateral incision into the chest, the other treatment and VAMT group the same. No adjuvant treatment was given after the two groups. Results The study group had less intraoperative blood loss (P<0.01), shorter hospital stay (P<0.05), and no significant difference in lymph node dissection compared with standard thoracotomy group (P>0.05). There were no operative deaths and serious complications in both groups, and there was no recurrence or metastasis in the follow-up. [Conclusion] Early peripheral lung cancer is treated with VATS assisted small incision, which is highly technically feasible and can be used as an alternative to traditional thoracic resection.