Abstract：Objective: To observe the effect of thoracoscopic segmentectomy for the treatment of early stage non-small cell lung cancer and its influence on cardiopulmonary function and evaluate its clinical value. Methods: Retrospective analysis 62 cases of patients with early-stage non-small cell lung cancer treated in our hospital from June 2015 to September 2017, 31 patients who received thoracoscopic lobectomy were as the routine group, 31 patients who received thoracoscopic segmentectomy were as the research group. The peri-operative period, intraoperative lymph node dissection, cardiac and pulmonary function before and after operation, postoperative complications, recurrence and the 1 year survival rate were analyzed and compared between the two groups. Results: The operation time of the study group was longer than that of the conventional group (P<0.05). However, the amount of bleeding, wound drainage, hospitalization time and dosage of analgesics in the study group were all lower than those in the conventional group (P<0.05). There was no significant difference in the number of total lymph node dissection and mediastinal lymph node dissection between the two groups (P>0.05). However, the incidence of postoperative complications was less than that of the conventional group (P<0.05); The forced expiratory volume (FVC), forced expiratory volume (FEV1) and maximum ventilation (MVV) in two groups before surgery were not significantly different between the two groups (P>0.05), after operation, FVC, FEV1 and MVV in both groups were increased (P<0.05), and the levels of FVC, FEV1 and MVV in the postoperative operation group were higher than those in the conventional group (P<0.05); Preoperative heart rate (HR), stroke volume per minute (SV), left ventricular ejection fraction (LVEF) no difference (P>0.05), after operation, the HR of both groups decreased (P<0.05), and the levels of SV and LVEF increased (P<0.05),the HR of the study group after surgery was significantly lower than that of the conventional group (P<0.05), study group SV, LVE increased more than the conventional group (P<0.05); Both groups had different degrees of recurrence postoperatively, but no recurrence was found between the two groups (P>0.05). The 1-year survival rate of the study group was significantly higher than that of the study group (P <0.05). Conclusion: Thoracoscopic resection of the lung segment for the treatment of early non-small cell lung cancer curative effect is exact, can reduce intraoperative bleeding, shorten hospital stay, reduce pain and reduce postoperative analgesic dosage, can improve cardiorespiratory function, and 1-year survival rate Higher, it is worth clinical promotion.
李传海, 莫修鑫, 孙之昀, 杜以营, 邹志强. 胸腔镜肺段切除治疗早期非小细胞肺癌的疗效及对心肺功能的影响[J]. 河北医学, 2018, 24(7): 1139-1143.
LI Chuanhai, MO Xiuxin, SUN Zhiyun, et al. Effect of Thoracoscopic Segmentectomy on Early Stage Non-small Cell Lung Cancer and its Influence on Cardiopulmonary Function. HeBei Med, 2018, 24(7): 1139-1143.
[1] 姚晓军,刘伦旭.肺癌的流行病学及治疗现状[J].现代肿瘤医,2014,22(8):1982~1986. [2] Herbst RS, Morgensztern D, Boshoff C.The biology and management of non-small cell lung cancer.Nature[J]. 2018,553(7689):446~454. [3] International Association for the Study of Lung Cancer,The IASLC Lung Cancer Staging Project: The New Database to Inform the Eighth Edition of the TNM Classification of Lung Cancer[J].Thorac Oncol.2014;9(10): 1618~1624. [4] European Society for Medical Oncology,Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up,Annals of Oncology[J].2017,28 (Supplement 4): 1~21. [5] 李鹏飞,赖玉田,周坤,等.应用Clavien-Dindo分级系统对肺癌患者术后并发症分级及危险因素分析[J].中国肺癌杂志,2017,20(4):264~271. [6] 杨继雷,姚秀叶,谷伟,等.参麦注射液联合左卡尼汀对慢性肺源性心脏病心肺功能的影响[J].中国临床药理学杂志,2016,32(5):396~398. [7] 齐海亮,李晓,隋锡朝,等.非小细胞肺癌患者胸腔镜肺叶切除术后复发模式分析[J].中华胸心血管外科杂志,2016,32(11):641~644. [8] Carbone D P, Reck M, Pazares L, et al. First-line nivolumab in stage IV or recurrent non-small-cell lung cancer.[J]. N Engl Med,2017,376(25):2415~2426. [9] Chun S G, Chen H, Choy H, et al. Impact of Intensity-Modulated Radiation Therapy Technique for Locally Advanced Non-Small-Cell Lung Cancer: A Secondary Analysis of the NRG Oncology RTOG 0617 Randomized Clinical Trial[J]. Journal of Clinical Oncology, 2017, 35(1):56~62. [10] Chen D, Du M, Yang T. Uniportal video-assisted thoracoscopic lobectomy for lung cancer.[J]. Journal of Thoracic Disease, 2016, 8(7):1830. [11] Jackute J, Zemaitis M, Pranys D,et al.Distribution of M1 and m2 macrophages in tumor islets and stroma in relation to prognosis of non-small cell lung cancer[J].BMC Immunol,2018,19(1):3. [12] Hwang Y,Kang C H,Kim H S, et al.Comparison of thoracoscopic segmentectomy and thoracoscopic lobectomy on the patients with non-small cell lung cancer: a propensity, score matching study[J]. International Journal of Theoretical Physics, 2015, 48(2):273~8. [13] Lex J R, Naidu B. In patients with resectable non-small-cell lung cancer, is video-assisted thoracoscopic segmentectomy an appropriate alternative to video-assisted thoracoscopic lobectomy[J]. Interactive Cardiovascular & Thoracic Surgery, 2016, 23(5): 202.
2018, Vol. 24 
冀公网安备13080202000786号