单向全胸腔镜术式在早期非小细胞肺癌外科治疗中的应用

The application of single-direction complete video-assisted thoracoscopic surgery in the surgical treatment of early non-small-cell lung carcinoma

目的探讨单向全胸腔镜术式在早期非小细胞肺癌外科治疗中的应用价值。方法随机选取2006年10月-2008年10月本院收治的早期非小细胞肺癌患者160例,其中单向式全胸腔镜手术（实验组）及传统开胸式手术（对照组）各80例,比较两组的手术时间、切口长度、失血量、淋巴结清扫数量、胸腔引流管留置时间、术后并发症发生率、术后VAS评分及术后1、3年的肿瘤复发情况。结果实验组较对照组切口长度短、失血量少、胸腔引流管留置时间短（P〈0.05）;两组的手术时间、淋巴结清扫数量及术后1、3年肿瘤复发情况差异无统计学意义（P〉0.05）。实验组的术后并发症发生率为65.00%,低于对照组的86.25%（χ^2=4.777,P=0.029）。实验组的VAS评分低于对照组（P〈0.05）。结论针对早期非小细胞肺癌,单项式全胸腔镜手术安全可行,较传统术式具有创伤小、出血少、疼痛轻、恢复快等优势。

Objective To discuss the application value of single-direction complete video-assisted thoracoscopic surgery in the surgical treatment of early non-small-cell lung carcinoma. Methods 160 patients with early non-small cell lung cancer treated in our hospital from October 2006 and October 2008 were randomly selected,among them 80 patients was treated with single-direction complete video-assisted thoracoscopic surgery（the experimental group） and80 patients was treated with the traditional thoracotomy（the control group）.The operation time,incision length,blood loss,number of lymph node dissection,chest tube indwelling time,incidence rate of postoperative complication, postoperative VAS score and tumor recurrence of postoperative 1 year and 3 years in the two groups were compared. Results The incision length was shorter,blood loss were fewer,chest tube indwelling time was shorter compared with the control group（P〈0.05）,and there was no statistical difference of the operation group,number of lymph node dissection,tumor recurrence of postoperative 1 year and 3 years in the two groups（P〉0.05）.The incidence rate of the experimental group（65.00%） was lower than that in the control group（86.25%）（χ^2=4.777,P=0.029）.VAS score in the experimental group was lower than that in the control group（P〈0.05）. Conclusion Single-direction complete video-assisted thoracoscopic surgery treating early non-small-cell lung carcinoma is safe,feasible,and it has advantages of small trauma,fewer blood loss,less pain,quick recovery and so on.