单孔与三孔胸腔镜治疗非小细胞肺癌患者近期结果对比分析

Short-term Outcome of Uniportal and Three Portal Video-assisted Thoracic Surgery for Patients with Non-small Cell Lung Cancer

背景与目的目前多孔胸腔镜肺部手术治疗肺部疾病的优势研究报道较多,但单孔和多孔胸腔镜(video-assisted thoracic surgery, VATS)之间的比较报道较少。本研究旨在评估单孔与三孔VATS两种手术方式对非小细胞肺癌(non-small cell lung cancer, NSCLC)患者术后近期疗效的比较。方法回顾性分析266例行单孔或三孔VATS肺癌根治术的患者,比较两组患者临床病理特征、围手术期资料和短期生活质量。结果两组患者临床病理特征无统计学差异(P>0.05);相较三孔组,单孔组术中出血量和术后引流量更少,术后胸管留置时间和术后住院时间更短(P<0.05),两组患者淋巴结清扫数目和站数无统计学差异(P>0.05)。单孔组术后疼痛得分明显低于三孔组(P<0.05)。单孔组总并发症、肺部并发症发生率低于三孔组,无统计学意义(P>0.05)。结论单孔VATS作为一种更加微创的手术,治疗可切除NSCLC安全有效,能够达到甚至优于三孔VATS手术效果。

Background and objective Currently, there are many reports on the advantages of three portal video-assisted thoracic surgery(VATS) in the treatment of lung cancer, but there are few reports on the comparison between uniportal and three portal video-assisted thoracic surgery. In this study, we aimed to evaluate the recent curative effect of the postoperative short-term quality of life between uniportal and three portal video-assisted thoracic surgery for non-small cell lung cancer. Methods We retrospectively evaluated 266 patients with NSCLC who underwent intended VATS lobectomy by a single surgical team in our ward between January 2016 and August 2017. The general clinical date, perioperative data and shortterm life quality were individually compared and analyzed between the two groups. Results The two groups were similar in terms of clinicopathological features, total number of dissected lymph nodes and nodal stations, postoperative complications and pulmonary complications(P>0.05). Compared with three portal VATS, the intraoperative blood loss, chest tube duration, postoperative thoracic drainage, length of stay and NRS score were significantly decreased in uniportal VATS, with significant differences(P<0.05). Conclusion As a more minimally invasive surgery, uniportal VATS can be safely and effectively performed for resectable lung cancer, which would achieve even better operation curative effect than three portal VATS.