非小细胞肺癌伴纵隔淋巴结肿大胸腔镜下纵隔淋巴结清扫的探讨.pdf

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1、2146临床肺科杂志2013年12月第18卷第12期非小细胞肺癌伴纵隔淋巴结肿大胸腔镜下纵隔淋巴结清扫的探讨¨1』]1J朱军翁鸢蔡铭段超陈晓峰【摘要】目的探讨非小细胞肺癌胸腔镜肺叶切除术与常规开胸肺叶切除术的淋巴结清扫差异。方法收集我院确诊的非小细胞肺癌伴纵隔淋巴结肿大(直径t>0．5cm)的患者98例，其中胸腔镜肺叶切除术40例，常规开胸肺叶切除术58例，术后两周均行PET．CT检查并明确纵隔淋巴结有无阳性。采用卡方检验分析两组术后淋巴结的清扫有无差异。结果PET—CT检查结果提示胸腔镜肺叶切除术组术后的纵隔淋巴结阳性率为7．50％(3／40)，常规开胸肺叶切除组术后的纵隔淋

2、巴结阳性率为5．17％(3／58)。两组术后淋巴结清扫比较无统计学差异(P>0．05)。结论胸腔镜肺叶切除术能够让非小细胞肺癌伴纵隔淋巴结肿大的患者取得与常规开胸肺叶切除术同样的效果。同时胸腔镜手术具有微创，术后恢复快等优点。【关键词】胸腔镜肺叶切除术；纵隔淋巴结；肺叶切除术；非小细胞肺癌；肺癌；PET—cT；微创手术Discussionoflymphnodesscavengeforpatientswithnon-smallcelllungcarcinomacomplicatedwithmediastinalymphadenectasisunderthoracoscopeZHU

3、JunI，WENGYuan

4、，CAIMing

5、，DUANChaoI，CHENXiao-fenfDe—partmentofThoracicSurgery，theForthPeoplesHospitalofAffiliatedtoJiangnanUniversity，Wuxi，Jiangsu2l4062．China【Abstract】ObjectiveTodiscusstheeffectofnon—smallcelllungcarcinomalymphnodesscavengebetweenthoracoscopelobecto—myoflungandcommonlobectomy

6、oflung．Methods98patientswithnon—smallcelllungcarcinomacomplicatedwithmediastinalymph—adenectasis(diameterI>0．05cm)werecollectedinourhospital，40ofwhomwereventhoracoscopelobectomyoflungandanother58patientsweregivencommonlobeetomyoflung．PET—CTexaminationwasdonefor98patientstwoweeksaftertheopera

7、tion．Thediferenceoflymphnodesscavengebetweenthetwogroupswereanalyzedbychi—squaretest．ResultsTheresultsofPET—CTshowedthattheposi—tiveexpressionofmediastinalymphadenectasiswas7．50％inthethoracoscopelobectomyoflunggroupand5．17％inthepulmonarylo—bectomygrouprespectively，whichshowednostatisticalsig

8、nificancebetweenthetwogroups．ConclusionLobectomyoflungunderthora—coscopehasthesimilarcurativeeffectwithcommonpulmonarylobectomyinthetreatmentofpatientswithnon—smallcelllungcarcinomacomplicatedwithmediastinalymphadenectasis，buttheformerhastheadvantagesofminimaltraumaandquickrecovery．【Keywords

9、】lobectomyoflungunderthoracoscope；mediastinalymphnodes；pulmonarylobectomy；non—smallcelllungcareino—ma；lungcancer；PET—CT；minimallyinvasiveoperation早期非小细胞肺癌目前采用的手术方式为常规后外侧切doi：10．3969／j．issn．1009—6663．2013．12．006口开胸肺叶切除术及淋巴结清扫术，或胸腔镜下肺叶切除术作者单位：1．21406