单孔胸腔镜手术治疗早期肺癌临床研究

Single-incision video-assisted thoracoscopic surgery in the treatment of early-stage lung cancer

目的对比单孔胸腔镜与传统三孔胸腔镜手术治疗早期肺癌的临床效果及安全性。方法回顾性分析2017年7月至2019年3月南京医科大学第一附属医院胸外科收治的早期肺癌患者114例的临床资料,其中46例行单孔胸腔镜手术(单孔组),68例行传统三孔胸腔镜手术(三孔组),比较两组在手术时间、术中出血、术中止血时间、淋巴结清扫数目、术后留置胸管时间、胸腔总引流量、术后住院时间、肺部并发症、术后疼痛程度及感觉异常等指标上的异同。结果单孔组的手术时间、止血时间、术后带管时间、胸腔总引流量、术后住院时间、术后1个月视觉模拟评分(VAS)及感觉异常率均显著优于三孔组(P <0. 05,P <0. 01),而两组术中出血、淋巴结清扫数目、术后肺部并发症、术后心律失常及术后第1天、拔管后、出院时VAS评分比较,差异无统计学意义(P均> 0. 05)。结论单孔胸腔镜手术治疗早期肺癌具有良好的临床效果及安全性,较三孔胸腔镜具有更大的优势。

Objective To compare the clinical effect and safety between single-incision and three-port video-assisted thoracoscopic surgery( VATS) in the treatment of early-stage lung cancer. Methods Out of 114 cases of early lung cancer reviewed from July 2017 to March 2019 retrospectively,there were 46 patients receiving single-incision VATS( singleincision group) and 68 patients undergoing conventional three-port VATS( three-port group). The operation time,blood loss,hemostasis time,number of lymph node cleaning,postoperative chest tube drainage duration,total thoracic drainage volume,postoperative hospital stay,pulmonary complications,pain degree and neurological symptoms were compared between two groups. Results The operation time,hemostasis time,postoperative chest tube drainage duration,total pleural drainage volume,postoperative hospital stay,VAS score and sensory abnormality rate at one month after operation in singleincision group were significantly better than those in three-port group( P < 0. 05,P < 0. 01). However,there were no statistical differences in blood loss,number of lymph node cleaning,pulmonary complications,postoperative arrhythmia and postoperative VAS score at one day after surgery,after extubation and at discharge between two groups( all P > 0. 05).Conclusion Single-incision VATS has better clinical effect and safety in the treatment of early-stage lung cancer compared with three-port VATS.