单孔胸腔镜与三孔胸腔镜肺癌术后恢复效果的比较分析

Comparative analysis of postoperative recovery between single-port and three ports VATS surgery of lung cancer

目的探讨单孔胸腔镜与三孔胸腔镜肺癌术后恢复效果,分析单孔胸腔镜的优势。方法回顾性分析137例肺癌患者的临床资料。单孔胸腔镜肺癌手术患者65例为观察组,三孔胸腔镜肺癌手术患者72例为对照组,比较2组术中出血量、手术时间、引流量、拔管时间、住院时间、术后第1天和第2天视觉模拟量表(Visual Analogue Scale,VAS)评分、术后有无肩关节活动障碍、术后第1个月和第3个月切口不适感及切口满意程度等。结果所有患者均在全胸腔镜下顺利完成手术,术后均未出现严重并发症。观察组与对照组在术中出血量、术后胸腔引流量、拔管时间、住院时间差异均无统计学意义(P>0.05),观察组手术时间长于对照组(P<0.05),术后第1天和第2天VAS评分低于对照组(P<0.05),术后第1个月和第3个月切口不适感发生率低于对照组(P<0.05),切口满意度高于对照组(P<0.05),肩关节活动障碍发生率明显低于对照组(P<0.05)。结论单孔胸腔镜技术在手术效果上与三孔胸腔镜相同,但是术后恢复效果明显优于后者,值得临床推广。

Objective To analysis the advanges of single-port video assisted thoracoscopic surgery（VATS）compared to three port-VATS in the lung cancer patitens.MethodsRetrospective analysis of clinical data of 137 patients with lung cancer were performed.Among the patients,65 cases undertook single-port VATS surgery were observation group,and 72 cases received three ports VATS were control group.The operation time,blood loss,postoperative drainage amount,chest tube drainage duration,postoperative hospital stay,the Visual Analogue Scale（VAS）score pain score of the 1st and 2nd postoperative day,shoulder disfunction,the incision discomfort in the 30 th and 90 th postoperative day,and the incision satisfaction degree were evaluated between the two groups.Results All the patients were underwent total VATS surgery successfully and no severe complications were observed.There were no significant difference on blood loss, postoperative drainage amount,chest tube drainage duration,postoperativep hospital day（P〈0.05）between the two groups.Compared to control group,renees in operation time was longer（P〈0.05）,the VAS score of the 1st and 2nd postoperative day was lower（P〈0.05）,the incision discomfort of 30 th and 90 th postoperative day was reduced and the incision satisfaetion degree was significantly improved（P〈0.05）,shoulder disfunction rate was lower（P〈0.05）in observation group.Conclusion Single-port VATS surgery had the same result cmopared with the three ports VATS,but the postoperative recovery is more better in single-port VATS surgery,which indicated single-port VATS surgery is worthy of clinical promotion.