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中华肺部疾病杂志(电子版) ›› 2022, Vol. 15 ›› Issue (01) : 76 -78. doi: 10.3877/cma.j.issn.1674-6902.2022.01.021

临床研究

Ⅰ期非小细胞肺癌微创肺段切除术效果分析
许建宁1, 孙健1, 王尧1, 郭冬冬1, 应开军1,()   
  1. 1. 224006 盐城,江苏省盐城市第一人民医院心胸外科
  • 收稿日期:2021-10-11 出版日期:2022-02-25
  • 通信作者: 应开军

Effect analysis of minimally invasive segmentectomy for stage I non-small cell lung cancer

Jianning Xu1, Jian Sun1, Yao Wang1   

  • Received:2021-10-11 Published:2022-02-25
引用本文:

许建宁, 孙健, 王尧, 郭冬冬, 应开军. Ⅰ期非小细胞肺癌微创肺段切除术效果分析[J]. 中华肺部疾病杂志(电子版), 2022, 15(01): 76-78.

Jianning Xu, Jian Sun, Yao Wang. Effect analysis of minimally invasive segmentectomy for stage I non-small cell lung cancer[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2022, 15(01): 76-78.

目的

分析Ⅰ期非小细胞肺癌(NSCLC)微创肺段切除术的应用及效果。

方法

选择2018年3月至2020年5月在我院肿瘤科接受治疗的Ⅰ期NSCLC患者57例,随机分为观察组26例,对照组31例。患者术前进行血生化、心电图、肺通气功能、胸部CT等检查。术后给予镇痛、防止感染、保持引流管通畅,鼓励患者下床活动、咳嗽、呼吸功能训练,促进肺复张。对照组患者采用常规开胸术切除肺段,观察组采用胸腔镜下行肺段切除术。两组患者手术相关指标,评价术后6个月的生活质量。术后并发症及术后12个月的复发率及生存率。

结果

与对照组相比,观察组手术时间、术中出血量、VAS评分、引流时间、引流量、住院时间、切口长度等手术指标明显降低(P<0.01)。观察组症状评分、功能评分、健康状况明显高于对照组(P<0.01)。患者术后出现的并发症有咯血、肺不张、皮下气肿、感染等。观察组患者术后并发症发生率为7.69%,明显低于对照组的35.45%(P<0.05)。

结论

胸腔镜肺段切除术治疗Ⅰ期NSCLC疗效明显,缩短住院时间、减轻患者术后疼痛程度,提高患者的生活质量,改善预后。

表1 两组患者手术相关指标比较(±s)
表2 两组患者生活质量评分比较(±s)
1
Jin X, Chen, Yanfan, et al. Evaluation of tumor-derived exosomal miRNA as potential diagnostic biomarkers for early stage non-small-cell lung cancer using next-generation sequencing[J]. Clin Cancer Res, 2017, 23(17): 5311.
2
Schläfli Anna M, Adams Olivia, Galván José A, et al. Prognostic value of the autophagy markers LC3 and p62/SQSTM1 in early-stage non-small cell lung cancer[J]. Oncotarget, 2016, 7(26): 39544-39555.
3
Yingying W, Yongqiang H, Lanjiao H, et al. Digoxin exerts anticancer activity on human nonsmall cell lung cancer cells by blocking PI3K/Akt pathway[J]. Biosc Rep, 2021, 41(10): 34549269.
4
Shaverdian N, Veruttipong D, Wang J, et al. Pretreatment immune parameters predict for overall survival and toxicity in early-stage non-small-cell lung cancer patients treated with stereotactic body radiation therapy[J]. Clin Lung Cancer, 2016, 17(1): 39-46.
5
Shen H, Wang X, Nie Y, et al. Minimally invasive surgery versus thoracotomy for resectable stage Ⅱ and Ⅲ non-small-cell lung cancers: a systematic review and meta-analysis[J]. Eur J Cardio-Thorac Surg, 2020, 59(5): 940-950.
6
Nagasaka Misako, Gadgeel Shirish M. Role of chemotherapy and targeted therapy in early-stage non-small cell lung cancer[J]. Expert Rev Anticancer Ther, 2017, 37(1): 630-639.
7
Fang WT, Chen TB, Luo JZ, et al. Minimally invasive surgery for centrally located lung cancers[J]. Zhonghua Wai Ke Za Zhi, 2020, 22(3): 131-133.
8
Raez LE, Lilenbaum R. Chemotherapy for advanced non-small-cell lung cancer[J]. Clin Adv Hematol Oncol, 2017, 2(3): 173-178.
9
张艳娇,高禹舜. 肺癌胸腔镜肺叶切除,胸腔镜肺段切除与开胸肺叶切除术后对肺功能影响的研究[J]. 中国肺癌杂志2016, 19(10): 5.
10
艾 波,张 霓,付向宁,等. 电视辅助胸腔镜下解剖性肺段切除术在双侧局限型支气管扩张症同期手术中的应用[J]. 中国胸心血管外科临床杂志2020, 27(8): 5.
11
Noronha V, Bhattacharjee A, Patil VM, et al. Aprepitant for cough suppression in advanced lung cancer: A randomized trial[J]. Chest, 2020, 157(6): 1647-1655.
12
Aix SP, Talbot D, Govindan R, et al. Quality of life with second or third line nab-paclitaxel-based regimens in advanced non-small-cell lung cancer[J]. Future Oncol, 2020, 16(7): 749-762.
13
钱桂生. 肺癌不同病理类型发病率的变化情况及其原因[J/CD]. 中华肺部疾病杂志(电子版), 2011, 4(1): 1-5.
14
陈 燏,王玉秀,闵凌峰. NIX蛋白表达与非小细胞肺癌临床病理特征及预后[J/CD]. 中华肺部疾病杂志(电子版), 2021, 14(4): 412-416.
15
Gallagher Shea P, Abolhoda Amir, Kirkpatrick Vincent E, et al. Learning curve of robotic segmentectomy for early-stage non-small cell lung cancer by a thoracic surgeon adept in open segmentectomy[J]. Innovations (Phila), 2018, 13(5): 321-327.
16
Albano D, Bilfinger T, Feraca M, et al. A multidisciplinary lung cancer program: Does it reduce delay between diagnosis and treatment?[J]. Lung, 2020, 198(6): 967-972.
17
Sudmeier L, Tian S, Higgins KA. Multidisciplinary management of brain metastases from non-small cell lung cancer in the Era of immunotherapy[J]. Current Treatment Options Oncol, 2021, 22(9): 22.
18
Hong Mi Jeong, Yoo Seung Soo, Choi Jin Eun, et al. Functional intronic variant of SLC5A10 affects DRG2 expression and survival outcomes of early-stage non-small-cell lung cancer[J]. Cancer Science, 2018, 109(12): 3902-3909.
19
Jacobs C, Fazzone B, Gerber MH, et al. Robotic lobectomy for lung cancer is safer than thoracotomy for high-risk patients[J]. J Am College Surg, 2020, 231(4): S292.
20
Chai T, Lin Y, Kang M, et al. Thoracotomy versus video-assisted thoracoscopic resection of lung cancer: A protocol for a systematic review and meta-analysis[J]. Med, 2019, 98(10): e14646.
21
Skrzypski M, Marczyk M, Szymanowska A, et al. Prognostic value of the expression of NKG2D and CD96 in early stage non-small cell lung cancer (NSCLC)[J]. Cancer Research, 2017, 77(13 Supplement): 3700-3700.
22
Wang L, Pei Y, Li S, et al. Outcomes of stereotactic body radiotherapy and surgery in treating early stage non-small cell lung cancer: A meta-analysis[J]. J Thoracic Oncol, 2017, 12(11): S2037-S2038.
23
Jian-Bo L, Ming-Lian Q, Chun-Jin L, et al. Simplified synchronous disconnection of pulmonary arteries and veins for right upper lobectomy[J]. Surg Endosc, 2020, 33(6): 2015-2023.
24
Cai K, Yan Y, Feng S, et al. Unidirectionally progressive resection of lower left lung carcinoma under video-associated thoracoscopy[J]. J Thoracic Dis, 2016, 7(12): 2371-2375.
25
蒋 浩,马永峰,曹新超,等. 直径小于2 cm肺癌胸腔镜肺叶切除术与肺段切除术临床比较分析[J]. 中国临床医生杂志2016, 44(4): 64-66.
26
Groen JV, Nynke M, Stijn VR, et al. Venous wedge and segment resection during pancreatoduodenectomy for pancreatic cancer: impact on short-and long-term outcomes in a nationwide cohort analysis[J]. British J Surg, 2021, 109(1): 96-104.
27
Cantini F, Niccoli L, Nannini C, et al. Isolated knee monoarthritis heralding resectable non-small-cell lung cancer. A paraneoplastic syndrome not previously described.[J]. Ann Rheumat Dis, 2016, 66(12): 1672-1674.
28
张志东,李 标. 早期非小细胞肺癌电视胸腔镜微创手术与常规手术淋巴结清扫的效果比较[J]. 现代肿瘤医学2019, 27(16): 4.
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