全胸腔镜与小切口开胸肺癌根治术治疗早期非小细胞肺癌的临床对比研究
发布时间：2019-04-25 21:16
【摘要】：[目的]比较完全胸腔镜下(c-VATS)肺癌根治术与小切口开胸(MIT)肺癌根治术治疗早期非小细胞肺癌(NSCLC)的手术情况,为胸外科肺癌手术患者术式的选择提供理论依据。[方法]选择2013年6月-2016年8月在昆明医科大学第二附属医院胸心血管外科住院并接受手术治疗的早期非小细胞肺癌患者122例,按手术方式分为c-VATS组和小切口开胸组。c-VATS组患者58例,该组患者行c-VATS下肺癌根治术;小切口开胸组患者64例,该组患者行MIT肺癌根治术。比较两组患者的手术时长、术中出血量、清扫淋巴结个数、术后第一天引流量、引流时间、住院费用、住院总天数、术后3个月和术后6个月复发情况等临床相关指标。应用SPSS22.0统计软件进行分析,计量资料以均数士标准差(x±S)表示,符合正态性的数据采用独立样本t检验进行分析,不服从正态性的采用非参数检验,计数资料采用卡方检验进行组间差异性分析。以P0.05为差异有统计学意义。[结果]两组患者顺利完成手术,无围手术期死亡病例,在接受后续治疗后均康复出院。c-VATS组患者手术时长(260.07±77.663)、术中清扫淋巴结个数(11.19±1.572)与开胸组手术时长(249.77±81.592)、术中清扫淋巴结个数(11.31±1.612)相比无显著差异,其结果无统计学意义(P0.05); c-VATS组患者术中出血量、术后第一天胸管引流量、引流时间、并发症发生率、住院总天数均低于开胸组,其差异有统计学意义(P0.05);而c-VATS组患者住院费用(39135.64±11125.783)高于开胸组(33827.05±13239.753),其差异有统计学意义(P0.05)。[结论]与小切口开胸手术相比,c-VATS肺癌根治术是临床上治疗非小细胞肺癌的有效手段,它具有术中创伤小、术后恢复快且并发症发生率低等优点,能进一步减少病人手术痛苦和缩短病人住院时间,适合临床推广。但是c-VATS肺癌根治术手术费用较小切口开胸手术高,对于一些家庭经济条件较为困难的患者而言,需酌情选择。
[Abstract]:[objective] to compare the results of total thoracoscopic (c-VATS) radical resection of lung cancer with small thoracotomy for (MIT) lung cancer in the treatment of early non-small cell lung cancer (NSCLC), so as to provide a theoretical basis for the choice of surgical procedures for patients with thoracic surgical lung cancer. [methods] from June 2013 to August 2016, 122 patients with early non-small cell lung cancer were admitted to the Department of Cardiovascular surgery of the second affiliated Hospital of Kunming Medical University. The patients were divided into c-VATS group and small incision thoracotomy group according to the operation mode. 58 patients in c-VATS group were treated with radical resection of lung cancer under c-VATS. 64 patients in the small incision thoracotomy group were treated with MIT lung cancer radical surgery. The length of operation, the amount of bleeding during operation, the number of lymph node dissection, the drainage flow on the first day after operation, the time of drainage, the cost of hospitalization, the total number of days in hospital, the recurrence of postoperative 3 months and 6 months after operation were compared between the two groups. The SPSS22.0 statistical software was used to analyze the data, and the measured data were expressed as the mean-plus-standard deviation (x-plus S). The normal data were analyzed by independent sample t-test, and the non-parametric test was used for the non-compliance with normality. Chi-square test was used to analyze the differences between groups. The difference was statistically significant (P0.05). [results] two groups of patients successfully completed the operation, there were no perioperative death cases, after receiving follow-up treatment, all recovered from hospital. The operation time in c-VATS group was (260.07 卤77.663), and the time of operation in c-group was (260.07 卤77.663). There was no significant difference in the number of lymph nodes between the two groups (11.19 卤1.572), (249.77 卤81.592) and (11.31 卤1.612) in the thoracotomy group, and there was no significant difference between the two groups (P0.05). The volume of intraoperative bleeding, drainage time, complications and total days of hospitalization in the c-VATS group were significantly lower than those in the thoracotomy group on the first day after operation (P0.05). The cost of hospitalization in c-VATS group (39135.64 卤11125.783) was significantly higher than that in open chest group (33827.05 卤13239.753) (P0.05). [conclusion] compared with small incision thoracotomy, radical resection of c-VATS lung cancer is an effective method for the treatment of non-small cell lung cancer. It has the advantages of less trauma, faster recovery and lower incidence of complications. It can further reduce the pain of operation and shorten the hospitalization time of patients, so it is suitable for clinical popularization. However, the cost of radical operation of c-VATS lung cancer is higher than that of small incision thoracotomy. For some patients with difficult family economic conditions, it is necessary to choose at their own discretion.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R734.2
[Abstract]:[objective] to compare the results of total thoracoscopic (c-VATS) radical resection of lung cancer with small thoracotomy for (MIT) lung cancer in the treatment of early non-small cell lung cancer (NSCLC), so as to provide a theoretical basis for the choice of surgical procedures for patients with thoracic surgical lung cancer. [methods] from June 2013 to August 2016, 122 patients with early non-small cell lung cancer were admitted to the Department of Cardiovascular surgery of the second affiliated Hospital of Kunming Medical University. The patients were divided into c-VATS group and small incision thoracotomy group according to the operation mode. 58 patients in c-VATS group were treated with radical resection of lung cancer under c-VATS. 64 patients in the small incision thoracotomy group were treated with MIT lung cancer radical surgery. The length of operation, the amount of bleeding during operation, the number of lymph node dissection, the drainage flow on the first day after operation, the time of drainage, the cost of hospitalization, the total number of days in hospital, the recurrence of postoperative 3 months and 6 months after operation were compared between the two groups. The SPSS22.0 statistical software was used to analyze the data, and the measured data were expressed as the mean-plus-standard deviation (x-plus S). The normal data were analyzed by independent sample t-test, and the non-parametric test was used for the non-compliance with normality. Chi-square test was used to analyze the differences between groups. The difference was statistically significant (P0.05). [results] two groups of patients successfully completed the operation, there were no perioperative death cases, after receiving follow-up treatment, all recovered from hospital. The operation time in c-VATS group was (260.07 卤77.663), and the time of operation in c-group was (260.07 卤77.663). There was no significant difference in the number of lymph nodes between the two groups (11.19 卤1.572), (249.77 卤81.592) and (11.31 卤1.612) in the thoracotomy group, and there was no significant difference between the two groups (P0.05). The volume of intraoperative bleeding, drainage time, complications and total days of hospitalization in the c-VATS group were significantly lower than those in the thoracotomy group on the first day after operation (P0.05). The cost of hospitalization in c-VATS group (39135.64 卤11125.783) was significantly higher than that in open chest group (33827.05 卤13239.753) (P0.05). [conclusion] compared with small incision thoracotomy, radical resection of c-VATS lung cancer is an effective method for the treatment of non-small cell lung cancer. It has the advantages of less trauma, faster recovery and lower incidence of complications. It can further reduce the pain of operation and shorten the hospitalization time of patients, so it is suitable for clinical popularization. However, the cost of radical operation of c-VATS lung cancer is higher than that of small incision thoracotomy. For some patients with difficult family economic conditions, it is necessary to choose at their own discretion.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R734.2
【参考文献】
相关期刊论文 前10条
1 朱佳龙;朱志军;侯量;胡思远;尹来波;;开胸肺癌根治术与完全胸腔镜下肺癌根治术治疗早期非小细胞肺癌的效果比较[J];现代诊断与治疗;2016年16期
2 杨凯云;陈安宁;赵光强;陈小波;雷玉洁;;单操作孔胸腔镜肺癌根治术对患者免疫功能的影响[J];昆明医科大学学报;2016年03期
3 王争君;朱琳燕;;电视胸腔镜与传统开胸手术治疗早期周围型肺癌的随机对照研究[J];实用癌症杂志;2016年02期
4 杨扬;李U，
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