单向式全腔镜肺叶切除术治疗外周型早期非小细胞肺癌的疗效及对预后的影响

Treatment effect of single-direction video-assisted thoracoscopic lobectomy in peripheral early-stage non-small cell lung cancer and its effect on prognosis

目的探究单向式全腔镜肺叶切除术治疗外周型早期非小细胞肺癌(NSCLC)的临床效果及对患者预后的影响。方法将138例外周型早期NSCLC患者按照手术方法的不同分为观察组(单向式全腔镜肺叶切除术)63例和对照组(全腔镜解剖性肺叶切除术)75例。比较两组患者的围手术期指标、术后疼痛程度、手术相关并发症以及术后复发率、生存率。结果观察组患者手术时间、术后住院时间均明显短于对照组,术中出血量及胸腔引流量均明显少于对照组,差异均有统计学意义(P﹤0.01)。术后第1、3、5天,观察组患者的视觉模拟评分法(VAS)评分均明显低于对照组,差异均有统计学意义(P﹤0.01)。两组患者并发症总发生率、复发率、累积生存率比较,差异均无统计学意义(P﹥0.05)。结论单向式全腔镜肺叶切除术能有效缩短手术时间,缓解外周型早期NSCLC患者术后疼痛,加快术后康复。

Objective To investigate the clinical effects of single-direction video-assisted thoracoscopic surgery(VATS) in thoracoscopic lobectomy for peripheral early-stage non-small cell lung cancer(NSCLC), as well as the impact on patients’ prognosis. Method The 138 patients with early-stage peripheral NSCLC were included in the research as study group(single-direction VATS lobectomy, n=63) and control group(VATS anatomic lobectomy, n=75), which were administered with different surgical approaches. The perioperative indicators, postoperative pain, surgery-related complications, postoperative recurrence and survival rates were recorded and compared between the two groups. Result The operative time and postoperative hospital stay of the study group were significantly shorter than those of the control group, besides, the intraoperative blood loss and chest drainage volume were significantly lower in study group than that in control group, with statistically significant difference noted(P<0.01). On 1, 3, and 5 d after surgery, the VAS scores in study group were evidently lower compared to control group, the difference was statistically significant(P<0.01). The overall incidence rate of complications, recurrence rate, as well as cumulative survival rate observed in the two groups were of insignificant difference(P>0.05). Conclusion Single-direction VATS can effectively shorten the operative time,relieve postoperative pain and accelerate postoperative recovery for patients with early-stage peripheral NSCLC.