单孔和单操作孔电视胸腔镜手术治疗胸部良性疾病的随机对照试验

Uniport versus Single Utility Port Video-assisted Thoracic Surgery for Benign Thoracic Diseases:A Randomized Controlled Trial

目的比较单孔和单操作孔电视胸腔镜手术（video．assistedthoracicsurgery，VATS）在胸部良性疾病手术中应用的优劣。方法选取2012年1月至2014年12月间由同一术者操作VATS的125例胸部良性疾病患者，随机选择单孔和单操作孔行VATS手术，其中单孔组65例，男41例、女24例，年龄（47．5±16．6）岁；单操作孔组60例，男39例、女21例，年龄（45．1±15．7）岁。比较两组围术期以及术后短中期随访结果。结果两组患者手术均按既定方案获得成功，无增加操作孔或中转开胸者。单孔组和单操作孔组手术时间[（48．9±11．3）minVS．（47．1±11．0）min】、术中出血量[（26．9±15．4）mlVS．（23．8±13．2）ml】、术后24h胸腔引流量[（81．5±36．9）m1vs．（77．3±31．2）m1]、术后胸腔引流管留置时间[（2．8±2．0）dvs．（3．4±2．2）d】、术后第3d疼痛评分【（2．6±1．2汾VS．（2．6±1．3）分】、术后住院时间[（4．9±2．1）dVS．（5．1±2．2）d】及术后并发症等指标上差异均无统计学意义（P〉O．05）。随访3～24个月，无1例复发。结论与单操作孔VATS比较，单孔VATS不延长手术时间，不增加耗材支出，具有微创、患者接受度高的优点，安全可行，值得推广应用。

Objective To discuss the advantage and disadvantage of uniport video-assisted thoracic surgery （VATS） versus single utility port VATS in the surgical treatment of benign thoracic diseases. Methods From January 2012 to December 2014, 125 patients with benign thoracic diseases who underwent VATS by the same performer were divided randomly into two groups including a uniport VATS group or a single utility port VATS group. There were 41 males and 24 females with a mean age of 47.5±16.6 years in the uniport VATS group. There were 39 males and 21 females with a mean age of 45.1±15.7 years in the single utility port VATS group. Then the patients were followed up. The perioperative data and follow-up results were compared between two groups. Results The total 125 patients of operations were performed successfully according the established plan, without increasing incisions or transferring to thoracotomy. There were no statistical differences between two groups in operative time （48.9±11.3 rain vs. 47.1±11.0 rain）, intraoperative bleeding volume （26.9±15.4 ml vs. 23.8±13.2 ml）, postoperative 24 h chest tube drainage volume （81.5±36.9 ml vs. 77.3±31.2 ml）, postoperative chest tube drainage time （2.8±2.0 d vs. 3.4±2.2 d）, the pain score on the 3rd postoperative day （2.6±1.2 points vs. 2.6±1.3 points）, average in-hospital stay （4.9±2.1 d vs. 5.1±2.2 d） or postoperative complications （P〉0.05）. The patients were followed up for 3-24 months. All patients achieved satisfactory results with no recurrence. Conclusions Compared with single utility port VATS, uniport VATS does not prolong operation time or consume more materials, and has advantages of minimally invasion and higher acceptance. It is a safe and feasible approach in surgical treatment of benign thoracic diseases and worthy of popularization and application.