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[目的]探讨电视纵隔镜手术在肺癌术前N分期临床应用价值。[方法]40例拟诊肺癌、纵隔淋巴结肿大患者采用全麻行颈部电视纵隔镜手术。[结果]40例患者经电视纵隔镜检查,未见纵隔淋巴结癌转移者15例,均中转开胸行肺叶切除加纵隔淋巴结清扫,术后病理诊断均为肺癌,其中14例纵隔淋巴结未见转移,与电视纵隔镜检查结果相符;1例隆突淋巴结可见癌转移,考虑取材部位不佳所致。病理证实纵隔淋巴结癌转移者24例,电视纵隔镜手术敏感度、特异性和准确性分别为95.8%、93.3%和94.9%。有1例发生严重出血并发症,无手术死亡病例。[结论]电视纵隔镜手术创伤小、安全性高,是确定肺癌术前N分期的有效方法。
[Objective] To investigate the clinical value of mediastinoscopy in preoperative N staging of lung cancer. [Method] Forty patients with suspected lung cancer and mediastinal lymph nodes were treated with cervical television mediastinoscopy under general anesthesia. [Results] Twenty-five patients underwent mediastinoscopy and no mediastinal lymph node metastasis was found. Fifteen patients underwent mediastinal thoracotomy and lobectomy plus mediastinal lymphadenectomy. Lung pathology was diagnosed postoperatively, and no mediastinal lymph node metastasis was found in 14 patients , Consistent with the results of television mediastinoscopy; 1 case of lymph node metastasis can be seen, taking into account the poor site. Twenty-four patients with metastatic mediastinal lymph nodes were confirmed by pathology. The sensitivity, specificity and accuracy of television mediastinoscopy were 95.8%, 93.3% and 94.9% respectively. One case of severe bleeding complications, no surgical deaths. [Conclusion] Video-mediastinoscopy is a safe and effective method to determine the preoperative N staging of lung cancer.