Efficacy of completely thoracoscopic lobectomy and thoracotomy in the treatment of non-small cell lung cancer and the influence on serum CEA,TK1 and blood gas indexes
10.3969/j.issn.1009-0754.2024.01.014
- VernacularTitle:全胸腔镜下肺叶切除术与开胸手术治疗非小细胞肺癌的疗效及对血清癌胚抗原、胸苷激酶1、血气指标的影响
- Author:
Zhi LI
1
;
Guihe CHEN
;
Zhongjin WANG
Author Information
1. 418000 湖南 怀化,湖南医药学院总医院胸外科
- Keywords:
Completely thoracoscopic lobectomy;
Mediastinal lymphadenectomy;
Non-small cell lung cancer;
Thoracotomy
- From:
Journal of Navy Medicine
2024;45(1):70-75
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the efficacy of completely thoracoscopic lobectomy and small-incision thoracotomy for pulmonary lobectomy in the treatment of non-small cell lung cancer and the influence on serum carcinoembryonic antigen(CEA),thymidine kinase 1(TK1)and blood gas indexes.Methods From April 2017 to March 2019,96 patients with non-small cell lung cancer diagnosed by pathological examination in Hunan University of Medicine General Hospital were randomly divided into control group and observation group,with 48 cases in each group.Completely thoracoscopic lobectomy was performed in the observation group,and thoracotomy for pulmonary lobectomy was performed in the control group.Mediastinal lymphadenectomy was given in both groups.The perioperative indexes and the incidence of postoperative complications were compared between the 2 groups.Venous blood was collected before and after the operation.The serum was collected to determine tumor necrosis factor-α(TNF-α),procalcitonin(PCT),hypersensitive C-reactive protein(hs-CRP),CEA,and TK1.The visual analogue scale(VAS)scores and radial artery blood gas indexes were compared between the 2 groups before and after surgery.The survival of the 2 groups was recorded during 2-year follow-up.Results The operative time,intraoperative blood loss,activity time out of bed and hospitalization time in the observation group were significantly lower than those in the control group(all P<0.05).No significant difference was found in the number of dissected lymph nodes between the 2 groups(P>0.05).Serum PCT,hs-CRP and TNF-α levels were increased after surgery in both groups,and these indexes in the observation group were significantly lower than those in the control group(all P<0.05).Partial pressure of oxygen(PaO2),partial pressure of carbon dioxide(PaCO2)and base excess(BE)levels were decreased after surgery in both groups.Postoperative PaO2 in the observation group was significantly higher than that in the control group(P<0.05).Serum CEA and TK1 levels in 2 groups after operation were significantly lower than those before operation(both P<0.05),but there was no significant difference in the CEA or TK1 between the groups(P>0.05).There was no significant difference in the preoperative VAS scores between the groups.The VAS scores on the 1st,3rd,and 7th day after operation in the observation group were significantly lower than those in the control group(P<0.05).The incidence of postoperative complications in the observation group was significantly lower than that in the control group(6.25% vs.22.92% ,P<0.05).After 24 months of follow-up,there was no significant difference in survival rate between the 2 groups(P>0.05).Conclusion Completely thoracoscopic lobectomy can effectively reduce postoperative pain,improve lung function,shorten hospitalization time,and has fewer complications.Its therapeutic effect is equivalent to small-incision thoracotomy.It is worthy of clinical promotion with both high efficiency and safety.
