3D胸腔镜与2D胸腔镜在单孔肺叶切除术中的临床对比研究

Clinical study of 3D versus 2D thoracoscopic surgeries in uniportal lobectomy

目的探讨3D胸腔镜在单孔肺叶切除术中的安全性及有效性。方法回顾性分析2018年9月至2019年5月于我院接受胸腔镜单孔肺叶切除术248例肺癌患者的临床资料。根据手术方法的不同将患者分为两组:3D胸腔镜组[76例,其中男52例、女24例,平均年龄(58.59±7.62)岁]和2D胸腔镜组[172例,其中男102例、女70例,平均年龄(57.75±8.59)岁]。分析患者临床病理资料、淋巴结清扫情况、手术并发症、术后住院时间等。结果3D胸腔镜组手术时间明显短于2D胸腔镜组(P<0.05),清扫淋巴结数目多于2D胸腔镜组(P<0.05),术后第1 d胸腔引流量多于2D胸腔镜组(P<0.05)。两组术后带管时间,术后住院时间,肺部感染、心律失常、支气管胸膜瘘、喉返神经损伤等发生率差异无统计学意义(P>0.05)。结论与传统的2D胸腔镜微创手术相比,应用3D胸腔镜行单孔肺叶切除术术中安全性更高、清扫淋巴结更加彻底、手术效率更高,值得推广。

Objective To investigate the safety and efficacy of 3 D thoracoscopic surgery in uniportal lobectomy.Methods Clinical data of 248 patients with lung cancer who underwent uniportal thoracoscopic lobectomy in our hospital from September 2018 to May 2019 were retrospectively analyzed.Patients were divided into two groups according to different surgical methods,a 3 D thoracoscopic group(76 patients,including 52 males and 24 females with an average age of 58.59±7.62 years)and a 2 D thoracoscopic group(172 patients,including 102 males and 70 females with an average age of 57.75±8.59 years).Statistical analysis of clinical and pathological data,lymph node dissection,surgical complications,postoperative hospital stay,etc was performed.Results Compared with the 2 D thoracoscopic group,the3 D thoracoscopic group had shorter operation time,more lymph nodes dissected and pleural effusion on the first day after operation(P<0.05).There was no significant difference in the postoperative chest tube duration,postoperative hospital stay,incidence of pulmonary infection,arrhythmia,bronchopleural fistula,or recurrent laryngeal nerve injury between the two groups.Conclusion Compared with the traditional 2 D thoracoscopic minimally invasive surgery,uniportal lobectomy with 3 D thoracoscopic surgery is safer and more efficient during operation,and lymph node dissection is more thorough,which is worth promoting.