胸腔镜单操作孔法与单孔法行肺叶切除术治疗早期非小细胞肺癌的临床效果比较

Comparison of clinical effects between single-port video-assisted versus single-incision thoracoscopic pulmonary lobectomy

目的比较胸腔镜单操作孔法与单孔法行肺叶切除术治疗早期非小细胞肺癌的临床效果。方法拟行胸腔镜肺叶切除术的早期非小细胞肺癌患者54例,分为单操作孔组及单孔组各27例。比较两组术中及术后一般临床观察指标、术后疼痛视觉模拟评分(VAS)、并发症发生情况。结果相较于单操作孔组,单孔组的手术时间长,术后至下床活动时间、术后拔管时间及住院时间短,术中淋巴结清扫个数多(均P<0.05);单孔组术后VAS评分低于单操作孔组,两组术后VAS评分均有随时间变化的趋势(均P<0.05);两组患者术后并发症比较,差异无统计学意义(P>0.05)。结论相较于胸腔镜单操作孔法,单孔法行肺叶切除术治疗早期非小细胞肺癌时创伤面积小,患者疼痛感较低,临床实用价值更高。

Objective To compare the clinical effects between single-port video-assisted versus single-incision thoracoscopic pulmonary lobectomy. Methods A total of 54 patients with early-stage non-small-cell lung carcinoma scheduled for thoracoscopic pulmonary lobectomy were divided into single-port video-assisted thoracoscopic surgery group（single-port group,n = 27） and single-incision thoracoscopic surgery group（single-incision group,n =27）. The general clinical observation indicators during and after operation,postoperative Visual Analogue Scale（VAS）score and incidence of complications were compared between the two groups. Results Compared to the single-port group,the single-incision group had more operation duration,less postoperative duration for ambulation,less postoperative duration for extubation and hospital stay,and more numbers of lymph nodes during radical dissection（all P〈0. 05）. After operation,the VAS score in the single-incision group was lower than that in the single-port group,and the VAS score changed over time in both groups（all P〈0. 05）. There was no significant difference in the incidence of postoperative complications between the two groups（P〉0. 05）. Conclusion Compared to the single-port video-assisted thoracoscopy,the single-incision thoracoscopy has the advantages of smaller wound area,milder pain and higher value of clinical practice in thoracoscopic lobectomy.