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最少侵入性肺切除术与开放性肺切除术:转换的结果和预测因素

Savan K Shah¹, Arsalan A Khan¹, Sanjib Basu²

¹Department of Cardiovascular and Thoracic Surgery, Rush University Medical Center, Chicago, Illinois.

The Annals of thoracic surgery

|August 10, 2024

概括

微创性肺切除术,包括机器人辅助 (RATS) 和视频辅助 (VATS) 方法,显示的生存结果相当于非小细胞肺癌 (NSCLC) 的开放手术. 这项研究发现,手术方法之间的短期或长期存活率没有显著差异.

科学领域:

胸部外科手术胸部外科手术
手术瘤学手术瘤学
肺部病理学肺部病理学

背景情况:

至少侵入性肺切除术与非小细胞肺癌 (NSCLC) 开放性肺切除术的生存益处尚不清楚.
评估手术方法对于优化患者在肺癌治疗中的结果至关重要.

研究的目的:

为了比较机器人辅助胸腔镜手术 (RATS),视频辅助胸腔镜手术 (VATS) 和NSCLC的开放性肺切除术的生存结果.
为了确定最小侵入性技术是否比传统的开放程序提供生存优势.

主要方法:

来自国家癌症数据库的2015-2020年间接受肺切除术的NSCLC患者的回顾性分析.
倾向性得分匹配用于平衡接受开放,VATS或RATS程序的队列.
单变量,多变量和考克斯比例危险模型分析了30天,90天的死亡率和整体存活率.

主要成果:

在倾向匹配后,在开放,VATS和RATS组之间没有观察到30天或90天死亡率的显著差异.
在所有手术方法中,平均整体存活时间是可比的 (开放式:48个月,VATS:51.0个月,RATS:50个月).
机器人辅助胸腔镜手术和新辅助化疗与转换为开放手术的风险降低有关.

结论:

最少侵入性肺切除术 (RATS和VATS) 实现了相当于NSCLC开放性肺切除术的短期和长期存活率.
手术方法似乎不会影响非小细胞肺癌患者的整体存活率.

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