胸腔镜辅助腋下小切口治疗原发性肺癌(1)
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[摘要] 目的：探讨胸腔镜辅助下做腋下小切口治疗原发性肺癌的临床应用价值。方法：回顾性分析2005年11月～2010年11月我院胸外科在胸腔镜辅助下做腋下小切口根治性肺叶切除术治疗的80例早期原发性肺癌患者(甲组)，同期100例传统开胸手术的原发性肺癌患者(乙组)，记录两组手术操作时间、术中淋巴结清扫数目、术后胸导管引流时间、平均住院时间、术中出血量和两组肺叶切除情况并进行比较。结果：180例患者均顺利完成肺叶切除术，两组肺叶切除情况、手术操作时间和术中淋巴结清扫数目比较，差异无统计学意义(P>0.05)。甲组术后胸腔引流时间[(3.01±0.51)d]、平均住院时间[(10.06±0.96)d]、术中出血量[(190.00±10.67)ml]均小于乙组的胸腔引流时间[(6.50±2.67)d]、平均住院时间[(16.97±2.58)d]、术中出血量[(298.00±30.14)ml]，两组比较，差异均有统计学意义(均P<0.05)。结论：胸腔镜辅助腋下小切口治疗原发性肺癌较常规开胸手术具有简单、操作快、出血少、创伤小、患者疼痛较轻、术后伤口较小、术后恢复快等优势，可同时用于诊断和治疗，值得临床应用与推广。
[关键词] 胸腔镜；腋下小切口；原发性肺癌
[中图分类号] R734.2 [文献标识码] A [文章编号] 1673-7210(2011)12(b)-036-03
Application of thoracoscopic assisted subaxillary small incision in the treatment of patients with primary lung cancer
QI Yongjun
Department of Cardiothoracic Surgery, Shougang Hospital of Peking University, Beijing 100041, China
[Abstract] Objective: To investigate the clinical significance of thoracoscopic assisted subaxillary small incision in the treatment of patients with primary lung cancer. Methods: 80 patients with early primary lung cancer underwent thoracoscopic assisted subaxillary smll incision (first group) and 100 patients with primary lung cancer unerwent traditional open surgery (second group) were collected and retrospecticvely analyzed, the surgery operating time, lymph dissection number, time of thoracic duct drainage, average in-hospital time, bleeding quantity and pulmonary lobectomy situation were recorded and compared. Results: There was no significant difference between the two groups in pulmonary lobectomy situation, surgery time and the lymph dissection number (P>0.05). The time of thoracic duct drainage, average in-hospital time and bleeding quantity of first group were (3.01±0.51) d, (10.06±0.96) d, (190.00±10.67) ml, significantly smaller than the second group which were (6.50±2.67) d, (16.97±2.58) d, (298.00±30.14) ml (P<0.05). Conclusion: The thoracoscopic assisted subaxillary small incision shows obvious advantages in simple operation, shorter surgery time, less bleeding quantity, smaller cut, slighter pain and fast recovery compared with traditional open surgery in treating primary lung cancer which deserves clinical application and population both in diagnosis and therapy ......
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