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| Clinical Effect and Influencing Factors of Total Thoracoscopic Lobectomy combined with Systemic Lymphadenectomy in the treatment of Lung Cancer |
| ZHANG Yin, YANG Min, WANG Jiaqi |
| Changshu Second People's Hospital, Jiangsu Changshu 215500, China |
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Abstract Objective: To investigate the clinical effect of video-asisted thoracoscopic surgery (VATS) combined with systematic lymphadenectomy in the treatment of lung cancer and the influencing factors. Methods: A total of 64 patients with lung cancer who were admitted to the hospital from January 2012 to July 2015 were enrolled in the study. They were divided into the observation group and the control group by the stratified random grouping, 32 cases in each group. The observation group was treated with VATS combined systematic lymphadenectomy, while the control group was treated with traditional open thoracotomy lobectomy and systemic lymphadenectomy. All patients were followed up for 3 years. Kaplan-Meier survival curve was used to analyze the median survival time and survival rate of both groups, and multivariate Cox regression analysis was performed to analyze factors affecting the clinical effect in the observation group. Results: The median survival time of the observation group was 27 months, and the 1-year, 2-year and 3-year survival rates were 87.50%, 68.75% and 40.63%. The median survival time of the control group was 25 months, and the 1-year, 2-year and 3-year survival rates were 84.38%, 62.50% and 34.38%. Kaplan-Meier survival curve analysis showed that there was no significant difference in overall survival time between the two groups (P>0.05). Univariate analysis showed that clinical stage, length of the lesion, tissue differentiation, number of lymph nodes removed and postoperative chemotherapy were closely related to the 3-year survival rates in the observation group (P<0.05). Multivariate Cox regression analysis showed that the clinical stage and the number of lymph nodes removed were independent factors influencing the prognosis in the observation group (P<0.05). Conclusion: The clinical effect of VATS combined with systematic lymphadenectomy is similar to that of traditional thoracotomy lobectomy combined with lymphadenectomy. Clinical stage and number of lymph nodes removed are independent influencing factors, which needs clinical attention.
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2019, Vol. 25 
