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目的探讨全胸腔镜手术对Ⅰ期非小细胞肺癌(NSCLC)的临床疗效。方法对95例早期NSCLC患者,采用全胸腔镜手术(VATS组,39例)和胸腔镜辅助小切口手术(VAMT组,56例),比较两组手术情况、淋巴结清扫及预后情况。结果 VATS组术中出血量少于VAMT组,住院时间略短于VAMT组,但无统计学差异。两组在手术时间、术后引流量、并发症方面无统计学差异。VATS组淋巴结阳性例数、个数与VAMT组比较无统计学差异,VAMT组均略高于VATS组。两组1、3年死亡率比较无统计学差异(P均>0.05)。VATS组生存率高于VAMT组,两组生存曲线比较有统计学差异(Log-rank,χ2=2.57,P=0.034)。结论Ⅰ期非小细胞肺癌全胸腔镜手术可彻底清扫纵隔淋巴结,并发症少,并能改善患者预后。
Objective To investigate the clinical effect of thoracoscopic surgery on stage Ⅰ non-small cell lung cancer (NSCLC). Methods Ninety - five patients with early stage NSCLC underwent total thoracoscopic surgery (VATS group, 39 cases) and thoracoscope - assisted small incision surgery (VAMT group, 56 cases). The operative conditions, lymph node dissection and prognosis were compared between the two groups. Results The VATS group had less blood loss during surgery than VAMT group, and the hospitalization time was slightly shorter than that of VAMT group, but there was no significant difference. There was no significant difference between the two groups in terms of operation time, postoperative drainage and complications. The number of positive lymph nodes in VATS group and the number of VAMT group were not statistically different, VAMT group were slightly higher than the VATS group. There was no significant difference between the two groups in 1 and 3-year mortality (P> 0.05). The survival rate of VATS group was higher than that of VAMT group. There was significant difference between the two groups (Log-rank, χ2 = 2.57, P = 0.034). Conclusion Stage Ⅰ non-small cell lung cancer thoracoscopic surgery can completely clean the mediastinal lymph nodes, fewer complications, and can improve the prognosis of patients.