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目的探讨胸腔镜肺亚叶切除术治疗Ⅰ期高龄非小细胞肺癌患者的临床疗效。方法将行手术治疗且术后病理为I期非小细胞肺癌的126例年龄>70岁的患者分为胸腔镜肺亚叶切除术组(59例)和胸腔镜肺叶切除术组(67例),分析比较两组患者的年龄分布情况、术后并发症、术后引流时间、住院天数及术后随访情况。结果 >75岁患者多选择胸腔镜肺亚叶切除术。胸腔镜肺叶切除术患者总体并发症发生率(40 7%)显著高于胸腔镜肺亚叶切除术患者(1 9.4%),差异有统计学意义(P=0 047)。胸腔镜肺亚叶切除术患者的平均术后引流时间、住院天数[(3 3±1.0)d、(8.5±1 5)d]短于胸腔镜肺叶切除术患者[(44±2.0)d、(12.8±2.0)d],差异均有统计学意义(均P<0.01)。两组患者2、3年生存率的差异均无统计学意义(均P>0.05)。结论胸腔镜肺亚叶切除术治疗老年I期非小细胞肺癌安全性良好,预后与肺叶切除术相似,可以作为老年Ⅰ期非小细胞肺癌患者尤其是不能耐受肺叶切除者一个较好的选择。
Objective To investigate the clinical efficacy of thoracoscopic lung lobectomy in the treatment of advanced stage non-small cell lung cancer. Methods One hundred and sixty-six patients (> 70 years old) undergoing surgery and postoperative pathology of stage I non-small cell lung cancer were divided into thoracoscopic lung lobectomy group (59 cases) and thoracoscopic lobectomy group (67 cases) . The age distribution, postoperative complications, postoperative drainage time, hospitalization days and postoperative follow-up were compared between the two groups. Results> 75 years old patients choose thoracoscopic lung sub-lobectomy. The overall complication rate in thoracoscopic lobectomy patients (40.7%) was significantly higher than that in thoracoscopic lung lobectomy patients (1.94%) (P = 0.047). The average duration of postoperative drainage and length of stay in patients undergoing thoracoscopic lung lobectomy was (3 3 ± 1.0) days, (8.5 ± 15 days) shorter than in patients undergoing thoracoscopic lobectomy (44 ± 2.0 days) (12.8 ± 2.0) d], the difference was statistically significant (both P <0.01). There was no significant difference in the two-and-three-year survival rates between the two groups (all P> 0.05). Conclusions Video-assisted thoracoscopic lung lobectomy is a safe and effective method for the treatment of elderly stage I non-small cell lung cancer. The prognosis is similar to that of lobectomy. It may be a better choice for elderly patients with stage I non-small cell lung cancer, especially those who can not tolerate lobectomy .