单操作孔胸腔镜肺叶切除术治疗早期非小细胞肺癌的临床疗效

Clinical effects of uniportal VATS thoracoscopic lobectomy on the patients with early stage primary lung cancer surgery

目的:探讨单操作孔胸腔镜手术(video-assisted thoracoscopic surgery,VATS)肺叶切除术对于早期肺癌患者手术治疗的临床效果。方法:回顾性分析2016年3月至2017年3月进行手术治疗的100例早期肺癌患者临床资料,分为观察组和对照组,各50例,观察组患者接受单操作孔VATS肺叶切除术或肺段切除治疗,对照组患者接受传统三孔式VATS肺叶切除术或肺段切除术治疗,比较两组患者的治疗效果、疼痛程度以及并发症发生率。结果:两组患者的手术时间、术中出血量、术中淋巴结清扫数目、术后下床时间、术后胸腔引流时间比较,差异均无统计学意义(P>0.05);观察组患者术后并发症发生率为4.0%(2/50),对照组患者术后并发症发生率为6.0%(3/50),组间比较,差异无统计学意义(χ2=0.211,P=0.646);观察组患者术后第7 d评分最小值(VASmin-d7)、术后第3 d及第7 d评分最大值(VASmax-d3、VASmax-d7)均低于对照组(P<0.05)。结论:单孔VATS肺癌根治术手术效果满意,安全可靠,创伤小,值得临床推广应用。

Objective ： To investigate the clinical effects of uniportal video - assisted thoracoscopic surgery （VATS） thoracoseopic lobectomy on the patients with early stage primary lung cancer surgery. Methods： 100 cases of early primary lung cancer patients from March 2016 to March 2017 in our hospital were retrospectively analyzed and divided into observation group and control group, with 50 cases in each group. The observation group underwent uniportal VATS pulmonary lobectomy or pulmonary segmentectomy, and the control group received the traditional three - hole VATS pulmonary lobeetomy or pulmonary segmentectomy. The clinical effects and parameters of the two groups were observed. Results： There were no statistical differences in operative time, intraoperative blood loss, number of lymph node dissection, thoracic drainage and length of stay in the two groups （ P 〉0.05 ） ; The occurrence rate of complication in the observation group was 4 % （2/50） , which had no difference compared with that in the control group （6 % , 3/50） （ X2 = 0.211 , P = 0. 646）. The VAS rain - d7, VAS max - d3 and VAS max - d7 in the observation group were better than those in the control group （ P 〈0. 05）. Conclusion：Uniportal VATS lobectomy for early stage primary lung cancer is effective, and the surgical trauma and postoperative recovery are better. It is worthy of recommendation.