单孔胸腔镜下肺叶切除术对周围型肺癌患者术中出血量、生存率及并发症的影响

Effect of single-port thoracoscopic lobectomy on blood loss, survival rate and complications in patients with peripheral lung cancer

目的探讨单孔胸腔镜下肺叶切除术对周围型肺癌患者的临床应用价值。方法选择2015年2月至2016年4月期间在本院接受治疗的78例周围型肺癌患者作为研究对象,依据手术方案的不同分为对照组和观察组各39例。对照组行三孔胸腔镜下肺叶切除术,观察组行单孔胸腔镜下肺叶切除术,比较两组围术期临床指标、生存率及并发症情况。结果两组淋巴结清扫数目及术后胸腔引流管拔除时间比较,差异无统计学意义(P>0.05);观察组术中出血量少于对照组,手术时间长于对照组,术后下床活动时间、住院时间及切口长度均短于对照组,差异均有统计学意义(P<0.05);两组患者术后1年生存率、术后2年生存率、并发症发生率比较,差异无统计学意义(P>0.05)。结论与三孔胸腔镜下肺叶切除术相较而言,周围型肺癌患者经单孔胸腔镜下肺叶切除术治疗,可在保证生存率、淋巴结清扫效果的前提下,减少出血量,缩短治疗时间,利于患者接受,且更具安全性。

Objective To investigate the clinical value of single-port thoracoscopic lobectomy for peripheral lung cancer.Methods A total of 78 patients with peripheral lung cancer treated in our hospital from February 2015 to April 2016 were selected as subjects.The patients were divided into two groups according to different surgical procedures:control group(39 cases with three-hole thoracoscopic lobectomy)and observation group(39 cases with single-hole thoracoscopic lobectomy).The perioperative clinical indicators,survival rate and complications of two groups were analyzed.Results There was no significant difference in the number of lymph node dissection and the time of thoracic drainage tube removal between the two groups(P>0.05).The amount of bleeding in the observation group was less than that in the control group,the operation time was longer than that in the control group,and the time of getting out of bed,hospital stay and incision length were shorter than those in the control group.The difference was statistically significant(P<0.05).There was no significant difference in 1-year survival rate and 2-year survival rate between the two groups(P>0.05);there was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Compared with three-port thoracoscopic lobectomy,single-port thoracoscopic lobectomy for peripheral lung cancer can reduce the amount of bleeding,shorten the treatment time,facilitate the acceptance of patients,and is more safe on the premise of guaranteeing survival rate and lymph node dissection effect.