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目的:探讨胸腔镜下肺叶切除手术治疗Ⅲa期非小细胞肺癌的可行性、安全性。方法:2005年1月至2007年12月间,对广州医学院第一附属医院116例进行电视胸腔镜下(全胸腔镜c-VATS组,68例;及胸腔镜辅助小切口a-VATS组,48例)肺叶切除术的Ⅲ期非小细胞肺癌患者进行了系统的分析。结果:17例患者的需要转变手术方式(由c-VATS到a-VATS,15例;由c-VATS到开放手术,1例;由a-VATS到开放手术,1例)。手术中转开胸1例。Ⅲa期108例,Ⅲb期8例,无围术期死亡,无严重并发症。全组手术时间平均(158±36)min,术中失血平均(176±50)mL,术后胸管停留时间平均(3.2±1.8)d,术后住院平均(7.5±2.5)d。结论:胸腔镜下肺叶切除手术治疗Ⅲ期非小细胞肺癌的是安全,有效的。
Objective: To investigate the feasibility and safety of thoracoscopic lobectomy in the treatment of stage Ⅲ a non-small cell lung cancer. Methods: From January 2005 to December 2007, 116 cases of First Affiliated Hospital of Guangzhou Medical College underwent video-assisted thoracoscopic surgery (VATS group, 68 cases); thoracoscope-assisted small-incision a-VATS group , 48 cases) Ⅲ lobectomy patients with non-small cell lung cancer were systematically analyzed. RESULTS: Seventeen patients needed to change their procedure (from c-VATS to a-VATS, 15; c-VATS to open surgery, 1; a-VATS to open surgery, 1). Transferred to open surgery in 1 case. 108 cases of stage Ⅲa, Ⅲb of 8 cases, no perioperative death, no serious complications. The mean operative time was (158 ± 36) min. The average blood loss during operation was (176 ± 50) mL. The mean postoperative chest residence time was 3.2 ± 1.8 days. The average postoperative hospital stay was (7.5 ± 2.5) days. Conclusion: Thoracoscopic lobectomy is a safe and effective treatment for stage Ⅲ non-small cell lung cancer.