单孔胸腔镜肺叶切除术与三孔胸腔镜肺叶切除术治疗周围型肺癌疗效分析

Analysis of curative effects of uniport video-assisted thoracoscopic lobectomy and threeport video-assisted thoracoscopic lobectomy for peripheral lung cancer

目的对比研究单孔胸腔镜肺叶切除术与三孔胸腔镜肺叶切除术治疗周围型肺癌的临床疗效。方法选择2017年1月~2020年1月周围型肺癌手术病例155例患者作为研究对象,根据患者自选手术方式分为D组77例和S组78例。D组手术方式为单孔胸腔镜肺叶切除术,S组手术方式为三孔胸腔镜肺叶切除术,比较两组患者围手术期各项临床数据以及术后疼痛评分和术后并发症。结果 D组手术时间长于S组,比较差异有统计学意义(P<0.05);D组其余围手术期数据与S组比较差异无统计学意义(P>0.05);D组术后一天疼痛及术后一个月疼痛均明显低于S组,比较差异有统计学意义(P<0.001);D组总并发症发生率3.90%与S组12.82%比较差异有统计学意义(P<0.05)。结论单孔胸腔镜肺叶切除术在治疗周围型肺癌的疗效与"三孔法"几乎相同,且在疼痛方面存在明显优势,是一种更加微创,更有前途的VATS肺叶切除术式。

Objective To compare the clinical efficacy of uniport video-assisted thoracoscopic lobectomy and threeport video-assisted thoracoscopic lobectomy in the treatment of peripheral lung cancer. Methods 155 peripheral lung cancer patients treated from January 2017 to January 2020 were selected as research objects, and all of them were divided into group D(77 cases) and group S(78 cases) according to different surgical modes. The Group D were treated with uniport video-assisted thoracoscopic lobectomy, and the group S were treated with threeport video-assisted thoracoscopic lobectomy. And then, perioperative clinical data and postoperative pain scores and postoperative complications were compared between the two groups. Results Operation time in the group D was longer than that in the group S, with statistically significant difference(P < 0.05);other perioperative data between the group D and the group S showed no statistically significant difference(P > 0.05);after one day and one month of surgery, pain degrees in the group D were lower than those of the group S, with statistically significant difference(P < 0.001);the overall complication rate in the group D and the group S was 3.90% and 12.82%, respectively, with statistically significant difference(P < 0.05). Conclusion The curative effect of uniport video-assisted thoracoscopic lobectomy in the treatment of peripheral lung cancer is almost the same as that of threeport video-assisted thoracoscopic lobectomy, and it has obvious advantages in decreasing pain degree, and it is a more minimally invasive and more promising VATS lobectomy.