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目的:观察全胸腔镜解剖性肺叶切除术(VATS)治疗非小细胞肺癌(NSCLC)的近期临床疗效。方法:回顾性分析2010年1月至2014年12月在汕头市中心医院进行手术的82例NSCLC患者的临床资料,分为全胸腔镜组(VATS组,48例)和开胸组(OT组,34例),对比两组临床疗效的差异,并按术前存在合并症及不同病理分期分层分析,采用Kaplan-Meier、Log-rank法进行生存分析。结果:两组手术时间、住院总费用、术后肺不张、肺漏气及房颤发生率、术后支气管残端阳性率、总费用比较,差异无统计学意义(P>0.05);VATS组术中出血量、输血例数、术后引流量,带管时间、术后住院时间、切口愈合时间、术后总体并发症、肺炎、切口感染发生率,术后化疗间隔时间均少于OT组(P<0.05);OT组术中淋巴结清扫站数及总数优于VATS组(P<0.05);VATS组手术费用及高值耗材费用高于OT组(P<0.05);VATS组和OT组1、3、5年生存率分别是95.8%、69.3%、52.9%和91.2%、62.8%、39.6%,两组比较,差异无统计学意义(P>0.05)。结论:与传统开胸手术相比,VATS具有出血量少、疼痛轻、可缩短术后开始化疗时间、术后并发症较少和住院时间短等优势,且能达到同样的淋巴结清扫效果。
Objective: To observe the short-term clinical efficacy of total thoracoscopic anatomical lobectomy (VATS) in the treatment of non-small cell lung cancer (NSCLC). Methods: The clinical data of 82 NSCLC patients who underwent surgery at Shantou Central Hospital from January 2010 to December 2014 were retrospectively analyzed. The data were divided into whole thoracoscopic group (VATS group, 48 cases) and thoracotomy group (OT group). , 34 cases), the difference between the two groups of clinical efficacy, and according to preoperative complications and stratified by different pathological analysis, using Kaplan-Meier, Log-rank method for survival analysis. RESULTS: There were no significant differences in operative time, total hospital expenses, postoperative pulmonary atelectasis, lung leak, atrial fibrillation, postoperative bronchial stump positive rate, and total cost between the two groups (P>0.05); VATS Intraoperative blood loss, number of blood transfusions, postoperative drainage, tube length, postoperative hospital stay, incision healing time, postoperative complications, pneumonia, incidence of incision infection, postoperative chemotherapy interval time were all less than OT Group (P <0.05); The number and total number of lymph node dissection stations in OT group was better than VATS group (P <0.05); The cost of operation and high value consumables in VATS group was higher than that in OT group (P <0.05); VATS group and OT The 1-, 3-, and 5-year survival rates were 95.8%, 69.3%, 52.9%, 91.2%, 62.8%, and 39.6%, respectively. There was no significant difference between the two groups (P>0.05). Conclusion: Compared with conventional open thoracic surgery, VATS has the advantages of less bleeding, less pain, shortened postoperative chemotherapy time, fewer postoperative complications and shorter hospital stay, and can achieve the same lymph node dissection results.