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目的 比较全胸腔镜下肺叶切除与小切口开胸手术在肺癌微创外科治疗中的临床应用.方法 回顾性分析2008年1月至2013年1月首都医科大学宣武医院胸外科行手术治疗的90例非小细胞肺癌患者,按手术方式分为完全胸腔镜组(n=47)及胸腔镜辅助小切口直视下手术组(n=43).比较两组患者淋巴结清扫数、手术时间、术中出血量、术后放置引流管时间、术后住院时间、术后并发症率、术后疼痛评分的差异.结果 两组患者淋巴结清扫数目、手术时间、术中出血量及术后并发症发生率差异均无统计学意义(均P＞0.05).全胸腔镜组术后放置引流管时间及术后住院天数明显少于胸腔镜辅助小切口组(P＜0.05).术后疼痛评分及镇痛药物使用量亦明显低于胸腔镜辅助小切口组(P＜0.05).结论 全胸腔镜下肺叶切除术相比胸腔镜辅助小切口可获得同样根治切除效果、安全可行,且术后恢复快.

Objective To explore the clinical application value of complete video-assisted thoracoscopic(cVATS) lobectomy in the mini-invasive treatment of lung cancer.Methods 90 patients with non-small cell lung cancer (NSCLC) who had undergone lobectomy were reviewed.According to surgical approach,complete video-assisted thoracoscopic lobectomy group (cVATS,n =47) and video-assisted minithoracotomy group(VAMT,n =43) were studied.Numbers of dissected lymph nodes,operation duration,volumes of intraoperative bleeding,duration of postoperative catheter drainage,length of postoperative hospital stay,incidence rates of postoperative complications,postoperative pain scores of patients were compared between the two groups retrospectively.Results There were no significant differences in numbers of dissected lymph nodes,operation duration,bleeding during operation,incidence rates of postoperative complication between the two groups (P ＞ 0.05).Duration of postoperative catheter drainage and length of postoperative hospital stay of patients in cVATS group were shorter than those in VAMT group (P ＜ 0.05).Pain scores of patients in cVATS group were lower than those at the same time in VAMT group (P ＜ 0.05).Conclusion Complete video-assisted thoracoscopic lobectomy is safe and effective surgical strategy for lung cancer patients with advantage of rapid recovery.