单孔和三孔胸腔镜下肺癌根治术的治疗效果和安全性

Efficacy and safety of single-versus three-port thoracoscopic lung cancer radical resection

目的探讨单孔和三孔胸腔镜下肺癌根治术的治疗效果和安全性。方法选取2013年3月至2018年2月间武汉市第一医院收治的93例行胸腔镜下肺癌根治术的非小细胞肺癌患者进行回顾性分析,根据手术方式不同分为单孔组(42例)和三孔组(51例)。单孔组患者采用单孔胸腔镜肺癌根治术,三孔组患者采用三孔胸腔镜肺癌根治术,比较两组患者手术创伤、疼痛、免疫功能及并发症发生率。结果单孔组患者手术时间长于三孔组患者,引流时间和引流液量均低于三孔组患者,差异均有统计学意义(均P <0. 05)。术前、术后1h和术后72h,两组患者疼痛评分比较,差异无统计学意义(P> 0. 05)。术后24h和术后48h,单孔组患者疼痛评分均低于三孔组患者,差异均有统计学意义(均P <0. 05)。术后24h,两组患者Ig G、Ig A及CD4+/CD8+较术前均降低,但单孔组患者水平均较高,差异均有统计学意义(均P <0. 05)。单孔组患者肺部感染发生率为2. 4%,低于三孔组患者的15. 7%,差异有统计学意义(P <0. 05)。结论与三孔胸腔镜下肺癌根治术患者比较,单孔胸腔镜下肺癌根治术能减轻手术创伤,降低对患者免疫功能损伤和肺部感染发生率,临床治疗效果显著。

Objective To explore the efficacy and safety of single-and three-hole thoracoscopic radical resection for lung cancer. Methods A total of 93 patients undergoing single-versus three-port thoracoscopic radical resection for lung cancer from March 2013 to February 2018 were selected and retrospectively analyzed. According to the thoracoscopic surgery patients received,the patients were divided into single-port group( 42 patients) and three-port group( 51 patients). Single-port group was treated with singleport thoracoscopic surgery and the three-port group was treated with three-port thoracoscopic surgery. Surgical trauma,pain,immunity function and incidence of complications were compared between the two groups.Results The time of operation was longer in the single-port group than in the three-port group but the drainage time and amount of drainage were lower in the single-port group than in the three-port group( all P<0. 05). There was no significant difference in pain scores between the two groups before operation,1 and 72 h after operation( P<0. 05). The pain scores were lower in the single-port group than in the threeport group at 24 and 48 h after operation( all P<0. 05). At 24 h after operation,Ig G,Ig A and CD4+/CD8+decreased in both groups compared before the surgery with decrease higher in the single-port group than in the three-port group( all P<0. 05). The incidence of pulmonary infection was 2. 4% in the singleport group which was lower than 15. 7% of the three-port group( P<0. 05). Conclusion Compared with three-port thoracoscopic lung cancer radical resection,one-port surgery has more significant clinical efficacy in reducing the surgical trauma,and the incidence of defects of the immune system and lung infection.