A Study of Complete Video-Assisted Thoracoscopic Surgery Lobectomy in Treatment of Elderly Patients with Non-Small Cell Lung Cancer: Curative Effect and Impact on Clinical Prognosis

摘要

The present study intends to investigate the clinical value of complete video-assisted thoracoscopic surgery (c-VATS) lobectomy in treatment of elderly patients with non-small cell lung cancer (NSCLC). A total of 100 cases of elderly patients with NSCLC admitted in our hospital from March 2012 to March 2014 were enrolled in this study and divided into the research group (n = 50) and control group (n = 50) by random sampling method. All patients in the research group underwent c-VATS lobectomy, while those in the control group underwent conventional lobectomy via thoracotomy. The duration of operation, length of incision, intraoperative blood loss, indwelling time of drainage tube, postoperative complication rate, the number of excised lymph nodes, the time of removing stitches, mean length of stay, and vision analog score (VAS) in two groups were observed and compared. The pulmonary function and arterial blood gas before surgery and six months after surgery in two groups were detected and compared. A regular follow-up study was conducted after surgery. The one-year survival rate in two groups were calculated and compared. The differences in the duration of operation, length of incision, indwelling time of drainage tube, postoperative complication rate, the time of removing stitches, mean length of stay, and VAS score between two groups were statistically significant (all P < 0.05). The postoperative vital capacity, forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1 to FVC ratio, 25 and 75 % of forced expiratory flow, and the degree of decline in maximum ventilatory volume per minute compared to that before surgery in c-VATS group were significantly less than those in conventional thoracotomy group (all P < 0.05). The degree of advance in postoperative partial pressure of arterial oxygen and saturation of arterial oxygen compared to those before surgery, and the degree of decline in partial pressure of arterial carbon dioxide compared to that before surgery were significantly greater than those in conventional thoracotomy group (all P < 0.05). The differences in intraoperative blood loss, the number of excised lymph nodes, and one-year survival rate were not statistically significant (all P > 0.05). VATS lobectomy has advantages of smaller incision in treatment of NSCLC, faster recovery, and better prognosis compared to traditional therapy.