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目的探讨胸腔镜下Ⅰ期非小细胞肺癌(NSCLC)根治术中淋巴结清扫的效果。方法收集经胸腔镜手术治疗74例(胸腔镜组)及开胸手术治疗80例(开胸组)的Ⅰ期NSCLC患者的临床资料,比较分析2组淋巴结清扫数目的差异,同时比较2组术中出血量、术后胸腔引流量、声音嘶哑、心肺总并发症的差异。结果胸腔镜组在双侧N2淋巴结清扫的数量高于开胸组(P<0.05);2组双侧N1淋巴结清扫数量差异无统计学意义(P>0.05);2组术中出血量、术后胸腔引流量、声音嘶哑发生率及心肺总并发症发生率差异均无统计学意义(P>0.05)。结论在Ⅰ期NSCLC根治术中,胸腔镜下系统性淋巴结清扫在技术上符合肿瘤外科原则,优于开胸手术。
Objective To investigate the effect of thoracoscopic lymphadenectomy in the treatment of stage Ⅰ non-small cell lung cancer (NSCLC). Methods The clinical data of 74 patients with thoracoscopic surgery (thoracoscope group) and 80 patients (thoracotomy group) with stage Ⅰ NSCLC underwent thoracoscopic surgery were collected. The differences of lymph node dissection between the two groups were compared and analyzed. The amount of bleeding, postoperative chest drainage, hoarseness, total cardiovascular and pulmonary complications. Results The number of bilateral N2 lymph node dissection in thoracoscope group was significantly higher than that in open thoracotomy group (P <0.05). There was no significant difference in the number of bilateral N1 lymph node dissection between the two groups (P> 0.05). The intraoperative blood loss, There was no significant difference in the incidence of posterior thoracic drainage, hoarseness of speech and general complication of cardiopulmonary respiration (P> 0.05). Conclusions In the first stage NSCLC radical surgery, thoracoscopic systematic lymph node dissection technically conforms to the principle of tumor surgery, which is better than thoracotomy.