单孔胸腔镜与三孔胸腔镜进行肺叶切除术的对比分析

Comparative analysis of single-hole thoracoscopy and three-hole thoracoscopy for lobectomy

目的 探讨单孔全胸腔镜及三孔胸腔镜在肺癌根治术中的安全性及临床意义,比较两种方法治疗肺癌的临床疗效。方法 选取2013年9月-2016年6月在我院行单孔胸腔镜及三孔胸腔镜手术的非小细胞肺癌患者共80例,所有手术操作均在胸腔镜下完成,比较两组患者的手术时间、术中出血量、术后住院时间、术后拔管时间、住院费用、淋巴结清扫、切口满意度等方面的差异。结果 单孔组中2例中转小切口辅助下完成手术,其余患者手术过程顺利,单孔组的手术时间较三孔组有延长,但其术中出血量、术后住院时间、术后拔管时间、淋巴结清扫及住院费用均无明显统计学差异（P〉0.05）。单孔组术后疼痛、对切口的满意度优于三孔组（P〈0.05）。结论单孔全胸腔镜下肺癌根治术的肿瘤临床恢复和手术安全性等同于三孔法手术,但在微创性、患者的疼痛、康复优于三孔法手术,患者对单孔胸腔手术的满意度更高。

Objective To study the safety and clinical significance of single-hole thoracoscopy and three-hole thora- coscopy in the radical treatment of lung cancer, and to compare the clinical efficacy of the two methods in the treatment of lung cancer. Methods A total of 80 patients with non-small cell lung cancer（NSCLC） who were given single-hole thoracoscopy and three-hole thoracoscopy from September 2013 to June 2016 were selected. All the operations were performed under thoracoscopy. The operation time, blood loss during surgery, postoperative hospital stay, postoperative extubation time, hospitalization cost, and satisfaction degree of prognostic incision after lymph node dissection were compared between the two groups. Results Two cases in the single-hole group were given the surgery assisted by mid- dle to small incision, and the surgery was successful in other patients. The operation time in the single-hole group was longer than that in the three-hole group. But there was no significant difference between the two groups in the blood loss during surgery, postoperative hospital stay, postoperative extubation time, lymph node dissection and hospitalization costs（P〉0.05）. The postoperative pain, satisfaction of incision of the single-hole group were superior to those of the three-hole group（P〈0.05）. Conclusion The clinical recovery and surgical safety of single-hole total thoracoscopic radical resection of lung cancer are equivalent to three-hole surgery, but the single-hole surgery is better than the threehole surgery in terms of the minimally invasiveness, patientls pain, and rehabilitation. Patients have a higher satisfaction with single-hole thoracoscopic surgery.