单操作孔和三孔胸腔镜肺段切除术治疗早期非小细胞肺癌的疗效对比

Efficacy comparison of segmentectomy under single-port and three-port thoracoscopy in the treatment of early non-small cell lung cancer

目的通过对比单操作孔和三孔胸腔镜肺段切除术治疗早期非小细胞肺癌的临床疗效,探讨单操作孔胸腔镜肺段切除术的临床应用前景。方法189例接受胸腔镜肺段切除手术治疗的早期非小细胞肺癌患者作为研究对象,根据手术方式分为单操作孔组(98例)和三孔组(91例)。单操作孔组患者采用单操作孔胸腔镜肺段切除术治疗,三孔组患者采用三孔胸腔镜肺段切除术治疗。比较两组的临床指标及术后并发症发生情况。结果两组患者的淋巴结清扫个数、术中出血量、引流管留置时间、术后住院时间以及术后并发症发生率比较差异均无统计学意义(P>0.05)。单操作孔组患者的手术时间(125.50±33.74)min略长于三孔组的(117.40±29.87)min,但差异无统计学意义(P>0.05)。单操作孔组患者的胸腔引流量(519.40±47.12)ml少于三孔组的(629.70±43.20)ml,且术后第1天疼痛评分(3.18±1.10)分和术后第3天疼痛评分(1.49±0.60)分均低于三孔组的(3.83±1.27)、(2.45±0.88)分,差异均具有统计学意义(P<0.05)。结论单操作孔胸腔镜肺段切除术是一种安全、可行的手术方式,值得推广应用。

Objective To discuss the clinical application prospect of single-port thoracoscopic segmentectomy by comparing the clinical efficacy of single-port and three-port thoracoscopic segmentectomy in the treatment of early non-small cell lung cancer.Methods A total of 189 cases of early non-small cell lung cancer undergoing thoracoscopic segmentectomy as study subjects were divided into single-port group(98 cases)and three-port group(91 cases).Single-port group was treated by single-port thoracoscopic segmentectomy,and three-port group was treated by three-port thoracoscopic segmentectomy.The clinical indicators and occurrence of postoperative complications were compared between the two groups.Results There was no statistically significant difference in number of lymph node dissections,amount of intraoperative hemorrhage,drainage tube indwelling time,postoperative hospitalization time and postoperative complications between the two groups(P>0.05).The operation time(125.50±33.74)min of single-port group was a little longer than that of three-port group(117.40±29.87)min,but the difference was not statistically significant(P>0.05).The thoracic drainage(519.40±47.12)ml of single-port group was less than that of three-port group(629.70±43.20)ml,pain score at postoperative 1st and 3rd day(3.18±1.10)and(1.49±0.60)points was lower than that of three-port group(3.83±1.27)and(2.45±0.88)points,and the difference was statistically significant(P<0.05).Conclusion Single-port and three-port thoracoscopic segmentectomy is safe and feasible,and it is worthy of clinical promotion and application.