不同胸外科医生主刀进行肺癌手术的患者生存差异分析李宁;牟巨伟;高树庚;赫捷;谭锋维;邱斌;李嘉根;赵峻;高禹舜;王大力;毛友生;薛奇【摘要】背景与目的外科医生是肺癌患者手术治疗的直接决策者和执行者,是否医生间的差异会影响到患者生存尚不清楚.本研究分析不同的胸外科医生手术治疗的患者5年生存率,评估医生的影响和作用.方法回顾性分析2002年-2007年5年间,在中国医学科学院肿瘤医院胸外科进行手术治疗的肺癌患者.依据不同主刀医生进行分组,比较患者基本信息、手术方式、短期结果和长期生存之间的差异.结果共有11位经验丰富的胸外科医生主刀治疗的712例患者纳入本研究.各位医生诊治患者的性别、年龄、吸烟、病理类型间无明显差异.而在临床分期、手术方式、手术时间、术中输血率、淋巴结清扫个数和姑息性切除比例、术后严重并发症发生率、围手术期死亡率等方面都存在显著差异.不同医生治疗患者5年生存率存在显著差异,这种差异在各临床期别分析中均可见到,具有一致性.多因素分析中提示主刀医生是影响患者预后生存的独立因素.结论主刀医生对于肺癌患者的治疗效果存在显著影响.%BackgroundandobjectiveSurgeonsarethedirectdecision-makersandperformersinthesurgicaltreatmentofpatientswithlungcancer.Whetherthedifferencesamongdoctorsaffectthesurvivalofpatientsisunclear.Thisstudyanalyzedthefive-yearsurvivalratesofdifferentthoracicsurgeriesinpatientsundergoingsurgerytoassessthephysician'simpactandimpact.MethodsAretrospectiveanalysisoffiveyearsbetween2002-2007intheDepartmentofThoracicSurgery,CancerHospital,ChineseAcademyofMedicalSci-ences,forsurgicaltreatmentoflungcancerpatients.Accordingtodifferentsurgeonsgroupingdoctorstocom-parethebasicinformationofpatients,surgicalmethods,short-termresultsandlong-termsurvivaldifferences.ResultsAtotalof712patientstreatedby11experiencedthoracicsurgeonswereincludedinthisstudy.Thepatientshavenosignificantdifferencewithgender,age,smoking,pathologicaltypebetweengroups.Thereweresignificantdifferencesinclinicalstaging,surgerytype,operationtime,bloodtransfusionrate,numberoflymphnodedissection,palliativeresectionrate,postoperativecomplicationsandperioperativemortality.Therewasasignificantdifferenceinfive-yearsurvivalratesamongpatientstreatedbydifferentdoctors.Thisdifferencecanbeseeninallclinicalstageanalyzeswithconsistency.Inthemultivariateanalysis,itwassuggestedthatsurgeonwasanindependentfactorinfluencingtheprognosisofpatients.ConclusionThoracicsurgeonhasasignificanteffectonthetherapeuticeffectoflungcancerpatients.【期刊名称】《中国肺癌杂志》【年(卷),期】2018(021)002【总页数】6页(P104-109)【关键词】肺肿瘤;外科;手术;