单孔与单操作孔胸腔镜肺叶切除术治疗肺结节比较研究

Comparasion of uniportal video-assisted and single utility port video-assisted pulmonary lobectomy in the treatment of pulmonary nodules

目的比较单孔与单操作孔胸腔镜肺叶切除术治疗肺结节的临床效果,探讨单孔胸腔镜技术在肺结节诊治中的临床应用价值。方法2017年8月至2018年7月滨州医学院附属医院胸外科共实施单孔胸腔镜肺叶切除术90例,与同期施行的单操作孔胸腔镜肺叶切除术81例患者进行对比研究。结果两组手术均无中转开胸,无围手术期死亡及严重并发症。两组手术时间、淋巴结清扫个数、并发症发生率比较差异无统计学意义(P>0.05);两组术中出血量、胸腔引流时间、住院时间、术后24 h和72 h疼痛评分有明显差异(P<0.05)。随访时间0~11(7.8±3.6)个月,无复发转移。结论单孔胸腔镜肺叶切除术术后恢复快、创伤更小,疼痛更轻,值得临床推广应用。

Objective To compare the clinical effects of uniportal video-assisted and single utility port video-assisted thoracic surgery in the treatment of pulmonary nodules,and explore the clinical value of uniportal video-assisted thoracic surgery in the diagnosis and treatment of pulmonary nodules.Methods From August 2017 to July 2018,department of thoracic surgery of Binzhou Medical University Hospital performed a total of 90 cases of uniportal video-assisted thoracic surgery,compared with 81 cases of single utility port video-assisted thoracic surgery at the same time.Results All the patients completed the operation successfully,no one was changed to open operation,no death or serious surgical complications during perioperative period.There were no significant differences in operation time,number of lymph node dissection,the incidence of postoperative complications between two groups(P>0.05).There were significant differences in blood loss,chest drainage time,hospital stay,postoperative 24 h and 72 h pain scores between two groups(P<0.05).There was no recurrent metastasis during 0~11(7.8±3.6)months follow-up time.Conclusion Uniportal video-assisted thoracic surgery is helpful for the early diagnosis and treatment of pulmonary nodules.The wound is smaller,the postoperative recovery is quicker with less postoperative pain,which is worthy of clinical application.