RÉSUMÉ
Objective To compare the clinical efficacies of video-assisted thoracoscopic segmentectomy versus lobectomy for early-stage non-small cell lung cancer.Methods The clinical data of 234 patients with stage ⅠA non-small cell lung cancer and undergoing different surgical methods under video-assisted thoracoscopy admitted to Chongqing Dianjiang General Hospital were retrospectively analyzed,and the patients were divided into the lung segment group and the lung lobe group according to their surgical methods.The clinical characteristics of the patients in the two groups were balanced by a 1-to-1 ratio matching through the propensity score matching method,and each group finally included 63 cases.The perioperative indicators containing operation time,intraoperative blood loss,postoperative thoracic drainage tube indwelling time,thoracic drainage volumes 24 hours and 48 hours after operation and postoperative hospital stay were compared of patients between the two groups.The incidence of postoperative complications such as air leakage>6 days,pulmonary infection,atelectasis,hemoptysis,and hoarseness in the two groups was collected.Results There was no significant difference in the operation time,intraoperative blood loss,thoracic drainage volumes 24 hours and 48 hours after operation,postoperative thoracic drainage tube indwelling time or incidence of postoperative complications of patients between the two groups(P>0.05).The postoperative hospital stay of patients in the lung segment group was shorter than that in the lung lobe group,with statistically significant difference(P=0.003).Conclusion For patients with stage ⅠA non-small cell lung cancer,video-assisted thoracoscopic segmentectomy has similar perioperative efficacy to lobectomy,while segmentectomy has a more significant advantage in shortening the hospital stay.
RÉSUMÉ
Objective To compare the efficacy and safety of robotic lobectomy and thoracoscopic lobectomy in early stage non-small cell lung cancer. Methods From January 2016 to January 2018, 113 patients with early-stage non-small-cell lung cancer who met the inclusion criteria were included in the same surgical group of thoracic and cardiac surgery department of the first affiliated hospital of nanchang university. According to the surgical method, they were randomly divided into robot-assisted thoracoscopic surgery (57 cases) and conventional thoracoscopic surgery (56 cases). Preoperative age (± 5 years) and relevant basic medical history were used to match the patients. The lymph node ascending rate, operative time, preoperative preparation time, intraoperative blood loss, drainage time, postoperative pain score on the second day, postoperative hospitalization time and perioperative complications of the two groups were compared prospectively. Results There was no significant difference in lymph node ascending rate, operation time, pain score on the second day after surgery and lymph node clearance number between the two groups. Intraoperative blood loss, drainage time and postoperative hospitalization time were lower than that of the thoracoscopy group (P < 0.05). The complication rate of the robot group was significantly lower than that in the thoracoscopy group (10.5％ vs. 26.7％, P < 0.05). The preoperative preparation time of the robot group was higher than that of the thoracoscopic group (P < 0.05). Conclusion Robot lobectomy is better and safer in patients with early non-small cell lung cancer than thoracoscopic lobectomy, and can be used in clinical application.
RÉSUMÉ
Non-small-cell lung cancer (NSCLC) patients with the same TNM stage may suffer from large prognosis variations. Even patients with early-stage NSCLC still demonstrated lower-than-expecting survival rates after surgical resection, indicating that the current staging methods which were based on anatomy do not adequately predict outcome. Especially the insufficient growth of very early period tumors limited the prognostic prediction of anatomy characteristics, therefore studies focusing on tumor biologic characteristics were developed in order to identify prognostic gene markers. A variety of prognostic genomic models were based on microarray analysis and quantitative polymerase chain reaction (PCR) and analyzed by bioinformatics data processing. However, the prognostic gene lists reported to date overlapped poorly in the studies with similar background. To improve the cloudy situation, the research protocol should be standardized.On the other hand, instead of simple addition of several genes, sequential combination of prognostic gene markers based on signal pathway should be developed which may possess much more rationality and systematicness.