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肺癌胸腔镜手术淋巴结清扫策略分析（附264例报告）
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肺癌胸腔镜手术淋巴结清扫策略分析（附264例报告）
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Journal Article
肺癌胸腔镜手术淋巴结清扫策略分析（附264例报告）
2013
Overview
目的探讨肺癌胸腔镜手术中淋巴结清扫的方法和操作要点。方法对解放军总医院胸外科2007年5月—2012年5月收治的264例肺癌患者行胸腔镜下肺叶切除术。其中右肺手术144例,术中清扫第2、3、4R、7、8、9、10、11组淋巴结,左肺手术120例,术中清扫第5、6、7、8、9、10、11组淋巴结。纵隔淋巴结按解剖区域行en bloc淋巴结清扫。对所有患者的病例资料及术后病理结果进行回顾性分析。结果所有患者均顺利完成手术,手术时间162.4±35.8min,术中出血量129.3±46.3ml。3例患者术后出现乳糜胸,经保守治疗后痊愈。2例患者术后出现声音嘶哑,1例于术后2个月恢复,1例未恢复。右肺手术清扫N1淋巴结8.7±1.2个,N2淋巴结10.6±1.4个;左肺手术清扫N1淋巴结8.2±1.4个,N2淋巴结9.2±1.3个。按解剖区域划分,共清扫右上纵隔淋巴结（含第2、3、4R组）4.2±0.9个,左上纵隔淋巴结（含第5、6组）2.8±1.0个,第7组淋巴结3.3±1.8个,下纵隔淋巴结（含第8、9组）2.1±0.7个。64例（24%）患者有N1淋巴结转移,21例（8%）患者有N2淋巴结转移,其中3例仅有N2淋巴结转移,无N1淋巴结转移。结论肺癌患者行胸腔镜手术时可同时完成淋巴结清扫。按解剖分区行en bloc淋巴结清扫是安全、可靠的方法。
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