The optimal treatment of stage ⅢA-N2 non-small cell lung cancer （NSCLC） remains controversial. Resultsof primary surgery alone are not satisfied. Surgery after induction chemotherapy yields better outcomes compared to resectiononly which has been widely accepted. Randomized studies show induction chemotherapy followed by either radiotherapy or surgery have approximately equivalent survival outcomes，significant improved survival can be achieved by combined surgery in selected patients. Low-grade N2，effective response and mediastinal downstaging after induction therapy，and successful complete resection by lobectomy，are good indications of surgery. Ideal treatments are approached base on theheterogeneity of N2 . Patients with bulky or fixed N2 disease should be considered for radical chemo-radiotherapy，and surgeryshould be a part of multi-modality management for patients with non-fixed，non-bulky，single-zone N2 disease. Further randomized trials of surgery added to multi-modality management in patients with multi-zone N2 disease should be taken in order to establish possible subgroups of patients might be benefitted more from the addition of surgery.
目的 探讨电视胸腔镜手术（VATS）在胸部刀刺伤中的应用价值。 方法 回顾性分析我院 2012～2015 年 22 例胸部刀刺伤行 VATS 诊治的临床资料。其中男 20 例、女 2 例，年龄 26.5（17～48）岁。 结果 行 VATS 18 例，肺破裂修补 12 例，出血血管钛夹、电凝止血 4 例，肺破裂及膈肌破裂修补 2 例；辅助小切口手术 2 例，肋间动脉缝扎止血 1 例，膈肌修补 1 例；中转开胸行心室壁修补术 1 例，胸腔镜下膈肌破裂修补合并开腹行肝破裂修补术 1 例。全组无手术死亡，无术后严重并发症。 结论 VATS 安全、有效、创伤小，早期应用有助于降低胸部刀刺伤患者的死亡风险。