浏览全部资源
扫码关注微信
不同手术方式治疗ⅠA期非小细胞肺癌的对比研究
A comparative study of different surgical method for stage ⅠA non-small cell lung cancer
- 局解手术学杂志 2024年33卷第3期 页码：226-229
- 作者机构：
1.川北医学院临床医学院，四川 南充637000
2.重庆市垫江县人民医院胸外科，重庆 408300
- 作者简介：
傅勇，E-mail：fuyong2006232@163.com
- 基金信息：重庆市科卫联合医学科研项目(2024MSXM054);重庆市垫江县科技局项目(djkjxm2021shmskjcxyw002)
DOI：10.11659/jjssx.10E023126
中图分类号： R734.2纸质出版日期：2024-03-25，
收稿日期：2023-10-27，
扫 描 看 全 文
何望,李童心,周瑜等.不同手术方式治疗ⅠA期非小细胞肺癌的对比研究[J].局解手术学杂志,2024,33(03):226-229.
HE Wang,LI Tong-xin,ZHOU Yu,et al.A comparative study of different surgical method for stage ⅠA non-small cell lung cancer[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(03):226-229.
何望,李童心,周瑜等.不同手术方式治疗ⅠA期非小细胞肺癌的对比研究[J].局解手术学杂志,2024,33(03):226-229. DOI： 10.11659/jjssx.10E023126.
HE Wang,LI Tong-xin,ZHOU Yu,et al.A comparative study of different surgical method for stage ⅠA non-small cell lung cancer[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(03):226-229. DOI： 10.11659/jjssx.10E023126.
摘要
目的
2
比较电视胸腔镜肺段切除术与肺叶切除术治疗早期非小细胞肺癌的临床疗效。
方法
2
回顾性分析重庆市垫江县人民医院234例行电视胸腔镜下不同手术方式治疗的ⅠA期非小细胞肺癌患者的临床资料，根据手术方式的不同将患者分为肺段组和肺叶组。通过倾向性评分匹配法进行1∶1匹配平衡2组临床特征，最终每组纳入63例患者。比较2组患者手术时间、术中出血量、术后胸腔引流管留置时间、术后24 h和48 h胸腔引流量及术后住院时间等围术期指标。统计2组患者术后漏气>6 d、肺部感染、肺不张、咯血、声音嘶哑等并发症发生情况。
结果
2
2组患者手术时间、术中出血量、术后24 h和48 h胸腔引流量、术后胸腔引流管留置时间及术后并发症发生率比较，差异均无统计学意义（
P
>
0.05）。肺段组患者的术后住院时间短于肺叶组，差异具有统计学意义（
P
=0.003）。
结论
2
对于ⅠA期非小细胞肺癌患者，电视胸腔镜肺段切除术与肺叶切除术具有相似的围术期疗效，但肺段切除术在缩短患者住院时间方面优势更明显。
Abstract
Objective
2
To compare the clinical efficacies of video-assisted thoracoscopic segmentectomy versus lobectomy for early-stage non-small cell lung cancer.
Methods
2
The clinical data of 234 patients with stage ⅠA non-small cell lung cancer and undergoing different surgical methods under video-assisted thoracoscopy admitted to Chongqing Dianjiang General Hospital were retrospectively analyzed， and the patients were divided into the lung segment group and the lung lobe group according to their surgical methods. The clinical characteristics of the patients in the two groups were balanced by a 1-to-1 ratio matching through the propensity score matching method， and each group finally included 63 cases. The perioperative indicators containing operation time， intraoperative blood loss， postoperative thoracic drainage tube indwelling time， thoracic drainage volumes 24 hours and 48 hours after operation and postoperative hospital stay were compared of patients between the two groups. The incidence of postoperative complications such as air leakage>6 days， pulmonary infection， atelectasis， hemoptysis， and hoarseness in the two groups was collected.
Results
2
There was no significant difference in the operation time， intraoperative blood loss， thoracic drainage volumes 24 hours and 48 hours after operation， postoperative thoracic drainage tube indwelling time or incidence of postoperative complications of patients between the two groups （
P
>
0.05）. The postoperative hospital stay of patients in the lung segment group was shorter than that in the lung lobe group， with statistically significant difference （
P
=0.003）.
Conclusion
2
For patients with stage ⅠA non-small cell lung cancer， video-assisted thoracoscopic segmentectomy has similar perioperative efficacy to lobectomy， while segmentectomy has a more significant advantage in shortening the hospital stay.
关键词
电视胸腔镜肺段切除术肺叶切除术早期非小细胞肺癌倾向性评分匹配
Keywords
video-assisted thoracoscopysegmentectomylobectomyearly-stage non-small cell lung cancerpropensity score matching
references
Billiet C，Chiairi I，Berzenji L，et al.Early-stage lung cancer：is there still a role for surgery？［J］.Rev Mal Respir，2020，37（9）：735-742.doi：10.1016/j.rmr.2020.06.018http://dx.doi.org/10.1016/j.rmr.2020.06.018.
Yendamuri S，Sharma R，Demmy M，et al.Temporal trends in outcomes following sublobar and lobar resections for small （≤2 cm） non-small cell lung cancers：a surveillance epidemiology end results database analysis［J］.J Surg Res，2013，183（1）：27-32.doi：10.1016/j.jss.2012.11.052http://dx.doi.org/10.1016/j.jss.2012.11.052.
Napolitano MA，Sparks AD，Werba G，et al.Video-assisted thoracoscopic surgery lung resection in United States veterans：trends and outcomes versus thoracotomy［J］.Thorac Cardiovasc Surg，2022，70（4）：346-354.doi：10.1055/s-0041-1728707http://dx.doi.org/10.1055/s-0041-1728707.
Bendixen M，Jørgensen OD，Kronborg C，et al.Postoperative pain and quality of life after lobectomy via video-assisted thoracoscopic surgery or anterolateral thoracotomy for early stage lung cancer：a randomised controlled trial［J］.Lancet Oncol，2016，17（6）：836-844.doi：10.1016/S1470-2045（16）00173-Xhttp://dx.doi.org/10.1016/S1470-2045（16）00173-X.
Scott WJ，Howington J，Feigenberg S，et al.Treatment of non-small cell lung cancer stage Ⅰ and stage Ⅱ：ACCP evidence-based clinical practice guidelines （2nd edition）［J］.Chest，2007，132（3 Suppl）：234S-242S.doi：10.1378/chest.07-1378http://dx.doi.org/10.1378/chest.07-1378.
Nakamura H，Kazuyuki S，Kawasaki N，et al.History of limited resection for non-small cell lung cancer［J］.Ann Thorac Cardiovasc Surg，2005，11（6）：356-362.
Nomori H，Shiraishi A，Yamazaki I，et al.Extent of segmentectomy that achieves greater lung preservation than lobectomy［J］.Ann Thorac Surg，2021，112（4）：1127-1133.doi：10.1016/j.athoracsur.2020.09.036http://dx.doi.org/10.1016/j.athoracsur.2020.09.036.
Chen L，Gu Z，Lin B，et al.Pulmonary function changes after thoracoscopic lobectomy versus intentional thoracoscopic segmentectomy for early-stage non-small cell lung cancer［J］.Transl Lung Cancer Res，2021，10（11）：4141-4151.doi：10.21037/tlcr-21-661http://dx.doi.org/10.21037/tlcr-21-661.
Xu Y，Qin Y，Ma D，et al.The impact of segmentectomy versus lobectomy on pulmonary function in patients with non-small-cell lung cancer：a meta-analysis［J］.J Cardiothorac Surg，2022，17（1）：107.doi：10.1186/s13019-022-01853-3http://dx.doi.org/10.1186/s13019-022-01853-3.
Saji H，Okada M，Tsuboi M，et al.Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer （JCOG0802/WJOG4607L）：a multicentre，open-label，phase 3，randomised，controlled，non-inferiority trial［J］.Lancet，2022，399（10335）：1607-1617.doi：10.1016/S0140-6736（21）02333-3http://dx.doi.org/10.1016/S0140-6736（21）02333-3.
Altorki NK，Wang X，Wigle D，et al.Perioperative mortality and morbidity after sublobar versus lobar resection for early-stage non-small-cell lung cancer：post-hoc analysis of an international，randomised，phase 3 trial （CALGB/Alliance 140503）［J］.Lancet Respir Med，2018，6（12）：915-924.doi：10.1016/S2213-2600（18）30411-9http://dx.doi.org/10.1016/S2213-2600（18）30411-9.
Mimae T，Okada M.Are segmentectomy and lobectomy comparable in terms of curative intent for early stage non-small cell lung cancer？［J］.Gen Thorac Cardiovasc Surg，2020，68（7）：703-706.doi：10.1007/s11748-019-01219-yhttp://dx.doi.org/10.1007/s11748-019-01219-y.
Martin-Ucar AE，Nakas A，Pilling JE，et al.A case-matched study of anatomical segmentectomy versus lobectomy for stage Ⅰ lung cancer in high-risk patients［J］.Eur J Cardiothorac Surg，2005，27（4）：675-679.doi：10.1016/j.ejcts.2005.01.006http://dx.doi.org/10.1016/j.ejcts.2005.01.006.
Kohman LJ，Gu L，Altorki N，et al.Biopsy first：lessons learned from cancer and leukemia group B （CALGB） 140503［J］.J Thorac Cardiovasc Surg，2017，153（6）：1592-1597.doi：10.1016/j.jtcvs.2016.12.045http://dx.doi.org/10.1016/j.jtcvs.2016.12.045.
Aokage K，Saji H，Suzuki K，et al.Lung cancer surgical study group of the Japan clinical oncology group.A non-randomized confirmatory trial of segmentectomy for clinical T1N0 lung cancer with dominant ground glass opacity based on thin-section computed tomography （JCOG1211）［J］.Gen Thorac Cardiovasc Surg，2017，65（5）：267-272.doi：10.1007/s11748-016-0741-1http://dx.doi.org/10.1007/s11748-016-0741-1.
Feng J，Wang LF，Han TY，et al.Survival outcomes of lobectomy versus segmentectomy in clinical stage Ⅰ non-small cell lung cancer：a meta-analysis［J］.Adv Ther，2021，38（7）：4130-4137.doi：10.1007/s12325-021-01793-9http://dx.doi.org/10.1007/s12325-021-01793-9.
Qu X，Wang K，Zhang T，et al.Long-term outcomes of stage Ⅰ NSCLC （≤3 cm） patients following segmentectomy are equivalent to lobectomy under analogous extent of lymph node removal：a PSM based analysis［J］.J Thorac Dis，2017，9（11）：4561-4573.doi：10.21037/jtd.2017.10.129http://dx.doi.org/10.21037/jtd.2017.10.129.
钟润波，王奕洋，韩宝惠，等.《中华医学会肺癌临床诊疗指南（2022版）》解读［J］.中国胸心血管外科临床杂志，2022，29（11）：1402-1406.doi：10.7507/1007-4848.202208073http://dx.doi.org/10.7507/1007-4848.202208073.
Kandathil A，Chamarthy M.Pulmonary vascular anatomy & anatomical variants［J］.Cardiovasc Diagn Ther，2018，8（3）：201-207.doi：10.21037/cdt.2018.01.04http://dx.doi.org/10.21037/cdt.2018.01.04.
Onuki T，Kanzaki M，Kikkawa T，et al.New findings on the three-dimensional anatomical relations between the bronchi and pulmonary blood vessels at the pulmonary hilum［J］.Clin Anat，2015，28（4）：506-511.doi：10.1002/ca.22486http://dx.doi.org/10.1002/ca.22486.
Rinieri P，Peillon C，Salaün M，et al.Perioperative outcomes of video- and robot-assisted segmentectomies［J］.Asian Cardiovasc Thorac Ann，2016，24（2）：145-151.doi：10.1177/0218492315627556http://dx.doi.org/10.1177/0218492315627556.
Demir A，Ayalp K，Ozkan B，et al.Robotic and video-assisted thoracic surgery lung segmentectomy for malignant and benign lesions［J］.Interact Cardiovasc Thorac Surg，2015，20（3）：304-309.doi：10.1093/icvts/ivu399http://dx.doi.org/10.1093/icvts/ivu399.
Hu CG，Yang XT，Zhao M，et al.Three-dimensional computed tomography bronchography and angiography-guided thoracoscopic segmentectomy for pulmonary nodules［J］.Surg Innov，2022，29（3）：343-352.doi：10.1177/15533506211044389http://dx.doi.org/10.1177/15533506211044389.
Hu W，Zhang K，Han X，et al.Three-dimensional computed tomography angiography and bronchography combined with three-dimensional printing for thoracoscopic pulmonary segmentectomy in stageⅠA non-small cell lung cancer［J］.J Thorac Dis，2021，13（2）：1187-1195.doi：10.21037/jtd-21-16http://dx.doi.org/10.21037/jtd-21-16.
Pontiki AA，Rhode K，Lampridis S，et al.Three-dimensional printing applications in thoracic surgery［J］.Thorac Surg Clin，2023，33（3）：273-281.doi：10.1016/j.thorsurg.2023.04.012http://dx.doi.org/10.1016/j.thorsurg.2023.04.012.
Tongxin L，Jing X，Runyuan W，et al.Application research of three-dimensional printing technology and three-dimensional computed tomography in segmentectomy［J］.Front Surg，2022，9：881076.doi：10.3389/fsurg.2022.881076http://dx.doi.org/10.3389/fsurg.2022.881076.
Gossot D，Seguin-Givelet A.The intersegmental plane：an emerging concern for the thoracoscopic surgeon［J］.Video Assist Thorac Surg，2017，2：34.doi：10.21037/vats.2017.05.06http://dx.doi.org/10.21037/vats.2017.05.06.
Andolfi M，Potenza R，Seguin-Givelet A，et al.Identification of the intersegmental plane during thoracoscopic segmentectomy：state of the art［J］.Interact Cardiovasc Thorac Surg，2020，30（3）：329-336.doi：10.1093/icvts/ivz278http://dx.doi.org/10.1093/icvts/ivz278.
Jiao P，Sun Y，Tian W，et al.Simple method for distinguishing the intersegmental plane in thoracoscopic lung segmentectomy［J］.Thorac Cancer，2020，11（6）：1758-1760.doi：10.1111/1759-7714.13417http://dx.doi.org/10.1111/1759-7714.13417.
0
浏览量
1
下载量
0
CSCD
- 网络PDF下载
- WORD下载
- Meta-XML下载
- BibTeX下载
- Endnote下载
- RefMan 下载
- NoteExpress下载
- NoteFirst下载
关联资源
相关文章
相关作者
相关机构
- 技术支持由北京北大方正电子有限公司提供 京ICP备09064830号-19
京公网安备11010802024621 - 本系统建议在Chrome、 IE9+ 以上版本浏览器阅读本站内容，360浏览器请切换至极速模式
- Cookies帮助我们提供服务并提供个性化体验。使用本网站，即表示您同意我们使用Cookies
