Objective: To evaluate the safety and efficacy of patients with centrally located lung cancer in sleeve lobectomy by video-assisted thoracic surgery (VATS). Methods: A retrospective analysis was performed on consecutive patients with centrally located lung cancer who underwent sleeve lobectomy admitted in the Affiliated Hospital of Qingdao University from January 2010 to September 2014. Propensity score matching analysis was performed to compare patients for thoracoscopic surgery and open surgery. Twenty-one pairs (42 cases) patients were included for analysis. The t-test, χ(2) test or Fisher's exact probabilities was adopted, if appropriate, to compare demographics and outcomes between the 2 groups. The Kaplan-Meier method and the Log-rank test were used for the distributions of disease free survival (DFS) and overall survival (OS) and their comparisons. Results: After propensity score-matched analysis, the VATS group had a longer operative time ((296.9±73.6) minutes vs. (218.1±59.2) minutes, t=3.82, P=0.00), but shorter postoperative drainage time ((3.3±1.5) days vs. (2.0±3.0) days, t=-0.93, P=0.01) and hospitalization time((6.7±2.8) days vs. (12.1±8.7)days, t=-1.72, P=0.01) than that of the thoracotomy group. Perioperative complications, 1-year and 3-year disease-free and overall survival rates were not statistically different between the two groups. Conclusion: For suitable patients, sleeve lobectomy by VATS is an acceptable safe and effective surgical procedure for patients with central lung cancer.
目的： 探讨胸腔镜袖式肺叶切除术治疗中心型肺癌的安全性与有效性。 方法： 回顾性分析2010年1月至2014年10月青岛大学附属医院胸外科施行的袖式肺叶切除术的中心型肺癌患者的临床资料，应用倾向性评分匹配法对胸腔镜手术和开放手术患者进行匹配，共21对42例患者纳入研究。采用t检验、χ(2)检验或Fisher精确概率检验比较两组患者手术指标，采用Kaplan－Meier曲线和Log－rank检验比较生存情况。 结果： 与开放组相比，腔镜组手术时间更长[(296.9±73.6)min比(218.1±59.2)min，t＝3.82，P＝0.00]，术后胸腔引流时间[(3.3±1.5)d比(2.0±3.0)d，t＝－0.93，P＝0.01]和住院时间[(6.7±2.8)d比(12.1±8.7)d，t＝－1.72，P＝0.01]更短。两组患者的围手术期并发症发生率、局部或远处复发率，1年、3年无病生存率和总体生存率差异均无统计学意义(P值均>0.05)。 结论： 胸腔镜袖式肺叶切除术治疗中心型肺癌安全性和有效性较好，可选择性应用于适宜患者。.
Keywords: Pneumonectomy; Sleeve lobectomy; Thoracoscopy; Treatment outcome.