• 1.中山大學(xué)腫瘤防治中心胸科;;
  • 2.中山大學(xué)肺癌研究中心;;
  • 3.華南腫瘤學(xué)國家重點實驗室, 廣州 510060;

目的比較電視胸腔鏡手術(shù)( video-assisted thoracoscopic surgery, VATS)與小切口開胸手術(shù)( minimal incision thoracotomy,MIT)治療臨床早期非小細(xì)胞肺癌( non-small cell lung cancer, NSCLC)及其兩種手術(shù)方式術(shù)后患者生活質(zhì)量的變化特點。方法我們的研究為前瞻性隨機(jī)對照臨床研究生活質(zhì)量的階段分析。共納入 2008 年 1月 1日至 2011年 12月 10日中山大學(xué)腫瘤防治中心收治的 106例 NSCLC患者(男 57例、女 49例,平均年齡57.60歲),采用單中心、雙盲試驗的隨機(jī)分組方法分為 VATS組(n=57)和 MIT組(n=49)。利用肺癌癥狀量表( Lung Cancer Symptom Scale,LCSS)評估兩組患者術(shù)前、術(shù)后第 1、3、6、9和 12個月的生活質(zhì)量。結(jié)果兩組患者在年 齡、性別、腫瘤所在肺葉、腫瘤病理分期、病理類型、術(shù)后并發(fā)癥、腫瘤直徑、手術(shù)時間、術(shù)中出血量和胸腔引流管置留 時間等方面差異無統(tǒng)計學(xué)意義( P>0.05)。術(shù)后 6個月中,VATS組內(nèi)各指標(biāo)評分與術(shù)前評分的差異無統(tǒng)計學(xué)意義 (P>0.05);MIT組內(nèi)術(shù)后 1個月食欲[(1.04±0.71)vs.(2.00±0.83),F(xiàn)=6.357,P=0.021]、疲勞[( 4.55±1.17) vs.(10.19±2.10),F(xiàn)=4.721,P=0.043]、氣促[( 2.18±0.86)vs.(10.26±2.05),F(xiàn)=10.020,P=0.005]及疾病對正常生活的影響[(5.16±1.70)vs.(17.60±3.17),F(xiàn)=12.319,P=0.002]評分與術(shù)前比較,差異有統(tǒng)計學(xué)意義。結(jié)論VATS行早期肺癌根治術(shù)后患者生活質(zhì)量與術(shù)前無明顯差異,術(shù)后恢復(fù)平穩(wěn)。

引用本文: 龍浩,鄭燕,林勇斌等. 電視胸腔鏡與小切口開胸治療臨床早期非小細(xì)胞肺癌患者術(shù)后生活質(zhì)量的前瞻性隨機(jī)對照研究. 中國胸心血管外科臨床雜志, 2012, 19(2): 130-135. doi: 復(fù)制

1. ?2 Nakamura H, Taniguchi Y, Miwa K, et al. Comparison of the surgical outcomes of thoracoscopic lobectomy, segmentectomy, and wedge resection for clinical stageⅠnon-small cell lung cancer. Thorac Cardiovasc Surg, 2011, 59(3):137-141.
2. ?3 Hollen PJ, Gralla RJ, Rittenberg CN. Quality of life as a clinical.
3. trial endpoint: determining the appropriate interval for repeated.
4. assessments in patients with advanced lung cancer. Support Care Cancer, 2004, 12(11):767-773.
5. ?4 Peterson DE, Bensadoun RJ, Lalla RV, et al. Supportive care treatment guidelines: value, limitations, and opportunities. Semin.
6. Oncol, 2011, 38(3):367-373.
7. ?5 Demmy TL, Nwogu C. Is video-assisted thoracic surgery lobectomy better? Quality of life considerations. Ann Thorac Surg, 2008, 85(2):S719-728.
8. ?6 Alonso Y. The biopsychosocial model in medical research: the evolution of the health concept over the last two decades. Patient Educ Couns, 2004, 53(2):239-244.
9. ?7 Donington JS, Koo CW, Ballas MS. Novel therapies for non-small cell lung cancer. J Thorac Imaging, 2011, 26(2):175-185.
10. ?8 Keogh JW, Jones L. The importance of promoting physical activity for cancer survivorship. N Z Med J, 2011, 124(1337):6-9.
11. ?9 Win T, Sharples L, Wells FC, et al. Effect of lung cancer surgery on quality of life. Thorax, 2005, 60(3):234-238.
12. Middleton J. Healthy people, healthy lives. The english public health white paper: risks and challenges for a new public health system. Clin Med, 2011, 11(5):430-433.
13. Balduyck B, Hendriks J, Sardari Nia P, et al. Quality of life after lung cancer surgery: a review. Minerva Chir, 2009, 64(6):655-663.
14. 龍浩, 林志潮, 林勇斌, 等. 早期非小細(xì)胞肺癌胸腔鏡手術(shù)與小切口肺切除術(shù)后患者生活質(zhì)量的對比研究 . 癌癥,2007, 26(6):624-628.
15. 龍浩,林志潮,林勇斌 , 等. 胸腔鏡與小切口開胸肺切除術(shù)后生活質(zhì)量的對比性研究. 中國微創(chuàng)外科雜志, 2008, 8(2):137-142.
16. 龍浩, 林志潮, 司徒冬榮, 等. 胸腔鏡手術(shù)與小切口開胸肺切除術(shù)后細(xì)胞因子反應(yīng)的隨機(jī)對照臨床研究. 癌癥,2007, 26(9):991-995.
17. Balduyck B, Hendriks J, Lauwers P, et al. Quality of life evolution after lung cancer surgery: a prospective study in 100 patients. Lung Cancer, 2007, 56(3):423-431.
18. Aoki T, Tsuchida M, Hashimoto T, et al. Quality of life after lung cancer surgery: video-assisted thoracic surgery versus thoracotomy. Heart Lung Circ, 2007, 16(4):285-289.
19. Li WW, Lee TW, Lam SS, et al. Quality of life following lung cancer resection: video-assisted thoracic surgery vs thoracotomy. Chest, 2002, 122(2):584-589.
20. Gorenstein LA, Sonett JR . The surgical management of stageⅠ and stageⅡ lung cancer. Surg Oncol Clin N Am, 2011, 20(4):.
21. D’Amico TA. Operative techniques in early-stage lung cancer. J Natl Compr Canc Netw, 2010, 8(7):807-813.
22. Handy JR Jr, Asaph JW, Douville EC, et al. Does video-assisted thoracoscopic lobectomy for lung cancer provide improved functional outcomes compared with open lobectomy? Eur J Cardiothorac Surg, 2010, 37(2):451-455.
23. Hollen PJ, Gralla RJ, Kris MG, et al. A comparison of visual analogue and numerical rating scale formats for the Lung Cancer Symptom Scale (lcss): does format affect patient ratings of symptoms and quality of life? Qual Life Res, 2005, 14(3):837-847.
24. -720.
  1. 1. ?2 Nakamura H, Taniguchi Y, Miwa K, et al. Comparison of the surgical outcomes of thoracoscopic lobectomy, segmentectomy, and wedge resection for clinical stageⅠnon-small cell lung cancer. Thorac Cardiovasc Surg, 2011, 59(3):137-141.
  2. 2. ?3 Hollen PJ, Gralla RJ, Rittenberg CN. Quality of life as a clinical.
  3. 3. trial endpoint: determining the appropriate interval for repeated.
  4. 4. assessments in patients with advanced lung cancer. Support Care Cancer, 2004, 12(11):767-773.
  5. 5. ?4 Peterson DE, Bensadoun RJ, Lalla RV, et al. Supportive care treatment guidelines: value, limitations, and opportunities. Semin.
  6. 6. Oncol, 2011, 38(3):367-373.
  7. 7. ?5 Demmy TL, Nwogu C. Is video-assisted thoracic surgery lobectomy better? Quality of life considerations. Ann Thorac Surg, 2008, 85(2):S719-728.
  8. 8. ?6 Alonso Y. The biopsychosocial model in medical research: the evolution of the health concept over the last two decades. Patient Educ Couns, 2004, 53(2):239-244.
  9. 9. ?7 Donington JS, Koo CW, Ballas MS. Novel therapies for non-small cell lung cancer. J Thorac Imaging, 2011, 26(2):175-185.
  10. 10. ?8 Keogh JW, Jones L. The importance of promoting physical activity for cancer survivorship. N Z Med J, 2011, 124(1337):6-9.
  11. 11. ?9 Win T, Sharples L, Wells FC, et al. Effect of lung cancer surgery on quality of life. Thorax, 2005, 60(3):234-238.
  12. 12. Middleton J. Healthy people, healthy lives. The english public health white paper: risks and challenges for a new public health system. Clin Med, 2011, 11(5):430-433.
  13. 13. Balduyck B, Hendriks J, Sardari Nia P, et al. Quality of life after lung cancer surgery: a review. Minerva Chir, 2009, 64(6):655-663.
  14. 14. 龍浩, 林志潮, 林勇斌, 等. 早期非小細(xì)胞肺癌胸腔鏡手術(shù)與小切口肺切除術(shù)后患者生活質(zhì)量的對比研究 . 癌癥,2007, 26(6):624-628.
  15. 15. 龍浩,林志潮,林勇斌 , 等. 胸腔鏡與小切口開胸肺切除術(shù)后生活質(zhì)量的對比性研究. 中國微創(chuàng)外科雜志, 2008, 8(2):137-142.
  16. 16. 龍浩, 林志潮, 司徒冬榮, 等. 胸腔鏡手術(shù)與小切口開胸肺切除術(shù)后細(xì)胞因子反應(yīng)的隨機(jī)對照臨床研究. 癌癥,2007, 26(9):991-995.
  17. 17. Balduyck B, Hendriks J, Lauwers P, et al. Quality of life evolution after lung cancer surgery: a prospective study in 100 patients. Lung Cancer, 2007, 56(3):423-431.
  18. 18. Aoki T, Tsuchida M, Hashimoto T, et al. Quality of life after lung cancer surgery: video-assisted thoracic surgery versus thoracotomy. Heart Lung Circ, 2007, 16(4):285-289.
  19. 19. Li WW, Lee TW, Lam SS, et al. Quality of life following lung cancer resection: video-assisted thoracic surgery vs thoracotomy. Chest, 2002, 122(2):584-589.
  20. 20. Gorenstein LA, Sonett JR . The surgical management of stageⅠ and stageⅡ lung cancer. Surg Oncol Clin N Am, 2011, 20(4):.
  21. 21. D’Amico TA. Operative techniques in early-stage lung cancer. J Natl Compr Canc Netw, 2010, 8(7):807-813.
  22. 22. Handy JR Jr, Asaph JW, Douville EC, et al. Does video-assisted thoracoscopic lobectomy for lung cancer provide improved functional outcomes compared with open lobectomy? Eur J Cardiothorac Surg, 2010, 37(2):451-455.
  23. 23. Hollen PJ, Gralla RJ, Kris MG, et al. A comparison of visual analogue and numerical rating scale formats for the Lung Cancer Symptom Scale (lcss): does format affect patient ratings of symptoms and quality of life? Qual Life Res, 2005, 14(3):837-847.
  24. 24. -720.