关键词: 肺肿瘤, 全胸腔镜肺叶切除, 开胸肺叶切除术, 淋巴结清扫

Abstract:

Objective To investigate the difference  of curative effects between the complete video assisted thoracic surgery (C-VATS) and traditional open surgery
 in the treatment of elderly patients with lung cancer, and to clarify the specially curative effect of C-VATS.Methods 80 patients with lung cancer without diabetes mellitus,chronic brouchitis and heart diseases aged over 65 years were enrolled in the study.They were divided into  C-VATS group and open surgery for lobectomy (OPEN) group (n=40) according their wishes. The operation time,number of lymph nodes removed,amount of intraoperative blood loss,postoperative thoracic drainage,chest tube duration,postoperative hospitalized time,postoperative pain degree,incidence of postoperative complications,preoperative and postoperative sedentary heart rate (HR) of the patients in two groups were compared.Results The operation time in C-VATS group(193.12 min±59.06 min) was longer than that in OPEN group(167.17 min±54.01 min)(P<0.05),and the number of lymph nodes removed in C-VATS group(14.6±7.5) had no significant difference compared with OPEN group(15.2±4.5)(P>0.05).The postoperative pain degree in C-VATS
 group(2.54±0.12) was lower than that in OPEN group(4.61±0.10)(P<0.05);the postoperative chest rube duration in C-VAS group(6.14 d±3.32 d) was shorter than that in   OPEN group  (11.67 d±4.13 d);the postperative hospitalized time in C-AVA group(8.52 d±3.25 d)was shorter than that in OPEN group

(14.76 d±6.11 d)(P<0.05).There were no significant differences of intraoperative blood loss(231.28 mL±203.15 mL vs 213.33 mL±187.18 mL),postoperative thoracic draginage(1 597.83 mL±1 049.29 mL vs  1 690.68 mL±1 043.37 mL),incidence of postoperative complications between C-VATS group and OPEN group(P>0.05).The postoperative sedentary HR in C-VATS group and  OPEN group were significantly higher than preoperative;the  postoperative sedentary HR recovered  to the preoperative level 3 d after operation in C-VATS group and it  recovered to the preoperative level  7 d after operation  in OPEN group.Conclusion Compared with traditional open thoracic surgery, C-VATS    owns the characteristics such as less trauma,less pain
,less hospital stay and better postoperative recovery in the aged patients with lung cancer.
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Key words: lung neoplasms, video-assisted thoracoscopic lobectomy, thoracotomy lobectomy, lymph node dissection