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[目的]分析单孔胸腔镜下解剖性肺段切除术在治疗Ⅰ期外周型非小细胞肺癌的可行性及安全性。[方法]回顾性分析2013年1月至2016年10月浙江省肿瘤医院30例诊断为Ⅰ期外周型非小细胞肺癌行单孔胸腔镜下解剖性肺段切除术的患者临床资料,平均年龄68.3岁,术前患者肺功能FEV1实测值/预计值平均为60.13%(43%~112.8%),术前胸部CT示肿瘤直径≤2.0cm。[结果]30例肺癌患者成功施行了单孔胸腔镜下解剖性肺段切除术,无增加辅助腔镜切口,无中转开胸,无中转行肺叶切除,无术后并发症及无围手术期死亡。平均手术时间110.7±30.5min,平均术中出血量93.5±30.5ml,术后胸腔引流管留置时间平均为3.5±2.1d,术后住院时间平均为6.5±1.6d,术中清扫淋巴结数平均为8.8±2.5枚。30例患者平均随访时间20.7(2~39)月,30例患者皆为无瘤生存,未发生转移或复发。[结论]单孔胸腔镜下解剖性肺段切除术治疗Ⅰ期外周型非小细胞肺癌是可行且安全的。
[Objective] To analyze the feasibility and safety of single-hole thoracoscopic anatomical segmentectomy for the treatment of stage I peripheral non-small cell lung cancer. [Methods] The clinical data of 30 patients diagnosed as stage Ⅰ peripheral non-small cell lung cancer undergoing single-hole thoracoscopic anatomic segmentectomy from January 2013 to October 2016 in Zhejiang Cancer Hospital were retrospectively analyzed. The mean age 68.3 years old, preoperative pulmonary function FEV1 measured / expected average of 60.13% (43% ~ 112.8%), preoperative chest CT showed tumor diameter ≤ 2.0cm. [Results] Thirty patients with lung cancer successfully underwent single-hole thoracoscopic anatomic segmentectomy with no additional endoscopic thoracotomy, no thoracotomy, no lobectomy, no postoperative complications and no perioperative period death. The average operation time was 110.7 ± 30.5min and the average blood loss was 93.5 ± 30.5ml. The average postoperative time of pleural drainage tube retention was 3.5 ± 2.1 days and the average postoperative hospital stay was 6.5 ± 1.6 days. The mean number of lymph nodes dissected during operation was 8.8 ± 2.5 pieces. The mean follow-up time was 20.7 (2-39) months in 30 patients. All 30 patients were tumor-free and had no metastasis or recurrence. [Conclusion] The single hole thoracoscopic anatomic segmentectomy for the treatment of stage I peripheral non-small cell lung cancer is feasible and safe.