胸腔镜和开放式气管癌切除术的真实世界瘤结果
Alexander Pohlman1,2,3, Bilal Odeh1,3, Julia M Coughlin3
1Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA.
Journal of thoracic disease
|November 13, 2025
概括
视频辅助胸腔镜手术 (VATS) 用于气管癌提供更短的住院时间,但与开放手术相比,带来更高的阳性边际和更差的生存率. 在采用VATS治疗气管癌时建议谨慎.
科学领域:
- 胸部外科手术 胸部外科手术
- 手术瘤学手术瘤学
- 最少侵入性手术的方法
背景情况:
- 视频辅助胸腔镜手术 (VATS) 越来越多地用于气管癌.
- 对于气管癌的VATS现有数据仅限于短期结果的单中心研究.
- 需要国家一级的数据来比较VATS与气管癌的开放切除.
研究的目的:
- 为了比较VATS的短期和长期瘤结果与开放式气管癌切除.
- 在全国范围内评估VATS对气管癌的安全性和有效性.
主要方法:
- 利用了2010年至2021年期间诊断的原发性气管癌的国家数据集.
- 将患者分为两层,分为开放式切除和VATS切除组.
- 使用的考克斯分析和倾向评分与混变量对照对照.
- 使用卡普兰-梅尔分析来评估5年生存率.
主要成果:
- 切除VATS与术后停留时间短 (2.5天而不是7.0天) 相联系.
- 在VATS患者中,阳性边缘率较高 (58.1%对41.0%),中位生存时间较差 (74个月对106个月).
- 这些结果在倾向性得分匹配后仍然存在.
结论:
- 对于气管癌,VATS的短期好处,如减少住院时间,被增加的阳性边际和较差的生存率所抵消.
- 由于这些瘤性权衡,对于气管癌的VATS的采用需要仔细考虑.
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