单孔与三孔胸腔镜肺叶切除术治疗周围型肺癌的临床疗效比较

Comparison of Efficacy Using Single-port and Three-port Thoracoscopic Lobectomy in Patients with Peripheral Lung Cancer

目的比较单孔与三孔胸腔镜肺叶切除术治疗周围型肺癌的临床疗效。方法选取行胸腔镜肺叶切除术的周围型肺癌患者176例,其中单孔组80例,三孔组96例,比较2组患者的手术时间、术中出血量、淋巴结清扫枚数、术后拔管时间、术后住院天数、切口长度、术后疼痛评分及并发症发生率等。结果单孔组在手术时间、术后拔管时间、术后住院天数方面要长于三孔组,而单孔组在切口长度、术后疼痛评分方面要优于三孔组,2组差异均有统计学意义(P<0.05)。单孔组与三孔组术中出血量、淋巴结清扫枚数及术后总并发症发生率比较,差异无统计学意义(P>0.05),但2组术后胸腔积液的并发症发生率存在差异有统计学意义(P<0.05)。结论单孔与三孔胸腔镜肺叶切除术临床效果基本相当,是安全有效的。单孔胸腔镜肺叶切除术可缩短切口长度,外表美观,术后患者疼痛减轻,有利于患者的术后恢复,值得临床上推广。

Objective To compare the efficacy of single-port and three-port thoracoscopic lobectomy in patients with peripheral lung cancer. Methods A total of 176 patients with peripheral lung cancer were divided into single-port（n=80） and three-port groups（n=96）. Clinical data,including operative time,intraoperative blood loss,number of lymph nodes dissected,postoperative extubation time,postoperative hospitalization,length of incision,postoperative pain score,and incidence of postoperative complications were compared between the two groups. Results In the single-port group,operative time,postoperative extubation time,and postoperative hospitalization were significantly longer than in the three-port group;however,the incision was shorter and the postoperative pain score was significantly lower than in the three-port group（P 〈0.05）.There were no significant differences in intraoperative blood loss,number of lymph nodes dissected,and incidence of postoperative complications between the two groups（P〉0.05）. However,the incidence of postoperative pleural effusion was higher in the single-port group than in the three-port group（P〈0.05）. Conclusion The clinical efficacy of single-port and three-port thoracoscopic lobectomy for peripheral lung cancer is basically the same,and both were safe and effective. Single-port thoracoscopic lobectomy can shorten the incision length,improve scar appearance,and reduce postoperative pain,and is beneficial for postoperative recovery. This technique should be promoted.