“单操作孔”电视胸腔镜下精准肺段切除术在早期肺癌患者中的应用

Application of "single operation hole" video-assisted thoracoscopic pre-cise segmentectomy in patients with early-stage lung cancer

目的探讨"单操作孔"电视胸腔镜下精准肺段切除术在早期肺癌患者中的应用。方法选取2018年10月~2019年5月我院收治的90例早期肺癌患者作为研究对象,按照手术方式的不同将其分为对照组(45例)与研究组(45例)。对照组患者采用"单操作孔"电视胸腔镜下肺叶切除术,研究组患者采用"单操作孔"电视胸腔镜下精准肺段切除术。比较两组患者的手术指标、术后疼痛[视觉模拟量表(VAS)]、手术前后肺功能[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)]变化及术后并发症发生情况。结果研究组患者的手术时间长于对照组,术中出血量、术后第1天胸腔引流量、术后胸腔引流总量均少于对照组,引流天数、术后住院天数均短于对照组,差异有统计学意义(P<0.05)。两组患者术后第1、2、3天的VAS评分比较,差异无统计学意义(P>0.05)。两组患者术后的FVC、FEV1均低于本组术前,研究组患者术后的FVC、FEV1均高于对照组,差异有统计学意义(P<0.05)。两组患者术后的并发症总发生率比较,差异无统计学意义(P>0.05)。结论 "单操作孔"电视胸腔镜下精准肺段切除术能减少术中出血量,缩短住院时间,更好地保留肺功能,可选择性应用于部分早期肺癌的患者。

Objective To explore the application of "single operation hole" video-assisted thoracoscopic precise segmentectomy in patients with early-stage lung cancer. Methods From October 2018 to May 2019, 90 patients with early-stage lung cancer treated in our hospital were selected as the research objects, according to different surgical procedure, they were divided into control group(45 cases) and study group(45 cases). The control group was treated with "single operation hole" video-assisted thoracoscopic lobectomy, while the study group was treated with "single operation hole" video-assisted thoracoscopic precise segmentectomy. The surgical indexes, postoperative pain(visual analogue scale [VAS]), changes of lung function(forced vital capacity [FVC], forced expiratory volume in one second [FEV1]) before and after surgery, and incidence of postoperative complications were compared between the two groups. Results The operation time in the study group was longer than that in the control group, intraoperative blood loss, the volume of thoracic drainage on the first day after surgery, and total postoperative thoracic drainage volume in the study group were less than those in the control group, and postoperative drainage days, postoperative hospital stay in the study group were shorter than those in the control group, the differences were statistically significant(P<0.05). There were no significant differences in VAS scores at the first, second, and third days after surgery between the two groups(P>0.05).The FVC and FEV1 in the two groups after surgery in the two groups were lower than those before surgery, FVC and FEV1 in the study group after surgery were higher than those in the control group, and the differences were statistically significant(P<0.05). There was no significant difference in the total incidence rate of postoperative complications between the two groups(P>0.05). Conclusion "Single operation hole" video-assisted thoracoscopic precise segmentectomy can reduce intraoperative blood loss, shorten hospital stay and better preserve the lung function of patients, which can be utilized as an option for those with early-stage lung cancer.