对比单孔、单操作孔及三孔胸腔镜肺叶切除术治疗早期非小细胞肺癌的临床研究

Efficacy comparison of uniportal video-assisted,single utility port video-assisted and 3-portal video-assisted thoracic surgery in patients with early non-small cell lung cancer

目的对比观察单孔、单操作孔及三孔胸腔镜治疗早期非小细胞肺癌(NSCLC)的临床疗效。方法选择125例早期NSCLC患者,分为单孔组(38例)单操作孔组(42例)和三孔胸腔镜组(45例),观察3组手术结果和并发症发生率。结果 3组患者均顺利完成手术,无中转开胸。单孔组手术时间长于单操作孔及三孔组,差异有统计学意义(P<0.05)。对比所有3组手术患者的术中出血量及淋巴结清扫数目、术后总引流量及引流管留置时间、术后并发症发生率,差异无统计学意义(P>0.05)。单孔组及单操作孔组术后疼痛程度评分优于三孔组,差异有统计学意义(P<0.05)。结论单孔及操作孔胸腔镜治疗早期NSCLC已可取代三孔胸腔镜技术,其术后恢复快,疗效确切,其中单孔手术对设备及胸腔镜医师操作技术熟练程度等要求更高,故在设备仍未有突破性的进展时,单操作孔胸腔镜手术可作为治疗早期NSCLC的优先选择。

Objective To compare the clinical effects of uniportal video-assisted thoracic surgery （VATS） ,single utility port VATS and 3-portal VATS lobectomy for patients with early stage non-small cell lung cancer. Methods Patients were divided into uniportal VATS lobectomy group （n = 3S） , single utility port VATS lobectomy group （n =42） and 3 -por-tal VATS lobectomy group （n =45） . The surgical results and complication rates were observed. Results All patients com-pleted the operation successfully, no one was changed to open operation. Operation time in uniportal VATS lobectomy group were longer than single utility port VATS lobectomy group and 3-portal VATS lobectomy group （ P 〈 0. 05 ）. There were no significant differences in intraoperative blood loss, number of lymph node dissection, the amount and time of postoperative ex- tubation, and the incidence of postoperative complications （ P 〉 0. 05）. Post-operative pain score were higher in 3-portal VATS lobectomy group than in uniportal VATS lobectomy group and single utility port VATS lobectomy group （P 〈0. 05）. Conclusion Uniportal VATS lobectomy and single utility port VATS lobectomy can replace the 3-portal VATS lobectomy in treatment of early NSCLC, because of the faster postoperative recovery and curative effect. Uniportal VATS lobectomy requires special equipment and more operation skills, as there is no breakthrough in the equipment, single utility port VATS lobectomy may still be used as the first choice for treatment of early NSCLC.