CVATS、VAMT、传统开胸三种手术方式治疗肺癌的近期临床疗效

Short-term clinical efficacy of the three surgical methods of CVATS,VAMT and traditional thoracotomy in the treatment of lung cancer

目的对比分析全胸腔镜手术(CVATS)、胸腔镜辅助小切口手术(VAMT)、传统开胸手术治疗肺癌的近期临床疗效。方法选取新乡医学院第一附属医院胸外科二病区2014年3月至2017年6月确诊的83例非小细胞肺癌患者作为研究对象,按照患者的病变、全身情况以及患者意愿分为三组,CVATS组(28例)、VAMT组(27例)、开胸组(28例)。对比分析三组患者手术时间、术中出血量、并发症发生情况、引流管放置时间、术后住院时间。结果三组患者手术时间、术中出血量、引流管放置时间、并发症总发生率、术后住院时间差异均有统计学意义(P<0.05)。CVATS组术中出血量、引流管放置时间、术后住院时间明显少于VAMT组和开胸组(P<0.05),VAMT组术中出血量、引流管放置时间、术后住院时间明显少于开胸组(P<0.05);开胸组手术时间明显短于CVATS组和VAMT组(P<0.05),VAMT组手术时间明显短于CVATS组(P<0.05)。CVATS组并发症总发生率明显低于开胸组(P<0.05)。结论 CVATS、VAMT和传统开胸手术治疗肺癌均能达到肺癌根治手术的要求。在创伤、术后恢复、安全性等方面,CVATS手术优于VAMT手术,VAMT手术优于传统开胸手术。因此,在肺癌根治术中,CVATS手术可作为首选手术方案。

Objective To compare and analyze the clinical efficacy of complete video-assisted thoracoscopic surgery(CVATS),video-assisted mini thoracotomy(VAMT)and traditional thoracotomy in the treatment of lung cancer.Methods A total of 83 cases of non-small cell lung cancer patients were selected as research subjects from March 2014 to June 2017 in the second ward of thoracic surgery department of the first affiliated hospital of Xinxiang medical college.According to the disease,the patients'general condition and patients'will,they were divided into three groups,CVATS group of 28 cases,VAMT group of 27 cases,thoracotomy group of 28 cases.The operation time,the amount of intraoperative blood loss,the complications,the time of drainage tube placement and the time of postoperative hospitalization of the three groups were compared and analyzed.Results There were significant differences in the operation time,the amount of intraoperative blood loss,the time of drainage tube placement,the total incidence of complications and the time of hospitalization in the three groups(P<0.05).The amount of intraoperative blood loss,the time of drainage tube placement and the time of postoperative hospitalization in the CVATS group were significantly less than those in the VAMT group and the thoracotomy group(P<0.05).The amount of intraoperative blood loss,the time of drainage tube placement and the time of postoperative hospitalization in the VAMT group were significantly less than those in the thoracotomy group,the differences were statistically significant(P<0.05).The operation time of the thoracotomy group was shorter than that of the CVATS group and the VAMT group(P<0.05),and that of the VAMT group was shorter than the CVATS group,the difference was statistically significant(P<0.05).The total incidence of complications in the CVATS group was significantly lower than that in the thoracotomy group(P<0.05).Conclusion CVATS,VAMT and traditional thoracotomy can meet the requirements of radical surgery for lung cancer.In terms of trauma,postoperative recovery and safety,CVATS is better than VAMT,and VAMT is superior to traditional thoracotomy.CVATS is the first choice in radical resection of lung cancer.