单孔胸腔镜肺叶切除治疗早期非小细胞肺癌效果分析

Effect of single-hole thoracoscopic lobectomy on patients with early non-small cell lung cancerr

目的分析杂交式单操作孔胸腔镜肺叶切除治疗早期非小细胞肺癌的临床疗效。方法早期非小细胞肺癌病人100例,根据手术方法不同分为观察组和对照组,每组各50例,观察组采取单操作孔胸腔镜肺叶切除术,对照组采取三孔胸腔镜肺叶切除术。比较两组病人手术资料、术后恢复情况及并发症发生率。结果所有病人顺利完成手术且术中未出现严重并发症。观察组手术时间及淋巴结清扫数目分别为(163.8±34.0)分钟和(12.5±1.9)个,对照组分别为(153.5±38.4)分钟和(12.3±1.6)个,两组比较差异无统计学意义(P>0.05),观察组术中出血量、切口长度、术后胸腔引流量、术后带管时间、术后住院时间及术后1天视觉模拟评分(visual analog scale,VAS)分别为(174.5±28.0)ml、(1.6±0.3)cm、(455.9±42.7)ml、(2.9±0.4)天、(9.6±1.2)天和(5.2±1.3)分,对照组分别为(225.7±30.0)ml、(4.2±0.6)cm、(620.6±67.3)ml、(3.5±0.5)天、(12.3±2.2)天和(6.5±1.7)分,两组比较差异均有统计学意义(P<0.05)。观察组术后并发症发生率为20.0%,对照组为40.0%,两组比较差异有统计学意义(P<0.05)。两组术后1年肿瘤复发率及生存率比较差异均无统计学意义(P>0.05)。结论对于局限于单个肺叶的早期非小细胞肺癌,杂交式单操作孔胸腔镜下肺叶切除术术中出血量少,术后恢复快,并发症发生率较低。

Objective To explore the effect of single-hole thoracoscopic lobectomy on patients with early non-small cell lung cancer.Methods A total of 100 patients with early non-small cell lung cancer received surgeries in our hospital from Jan 2014 to Jan 2015.They were divided into observation group（single-hole thoracoscopic lobectomy,50 cases）and control group（three thoracoscopic lobcctomy,50 cases）according to operation modes.The operation data,postoperative recovery situations and complication rate were compared between two groups.Results All patients completed operations successfully and there were no serious complications during operations.There were no significant differences in operation time,numbers of lymph node dissection,tumor recurrence rate and survival rate in one year after operations be-tween the two groups（P 〉 0.05）.The blood loss,length of incision,thoracic drainage,tube time,postoper-ative hospital stay and VAS scores at the first day after surgery in observation group were lower than those in control group（P 〈 0.05）.The complication rate of observation group[20.0%（10/50）]was lower than that of control group[40.0%（20/50）]（P 〈 0.05）.Conclusion As for patients suffered from ear-ly non-small cell lung cancer,single-hole thoracoscopic lobectomy has advantages of less bleeding,fast re-covery and low complication rate.