三维重建在单操作孔胸腔镜肺段切除术治疗早期非小细胞肺癌中的应用:一项倾向性评分匹配研究

Application of Three-dimensional Reconstruction in Single Utility-port Thoracoscopic Segmentectomy for Early Stage Non-small Cell Lung Cancer:A Propensity Scorematched Analysis

目的利用倾向性评分匹配(PSM)研究三维重建在单操作孔胸腔镜肺段切除术治疗早期非小细胞肺癌(NSCLC)中的价值。方法回顾性分析150例行单操作孔胸腔镜肺段切除术的早期NSCLC患者的临床资料。根据术前是否行三维重建分为重建组(58例)和非重建组(92例)。对两组患者进行PSM,比较两组患者的围手术期结果。结果两组患者均顺利完成手术,无围手术期死亡。通过对术前8个混杂因素(年龄、性别、吸烟史、BMI、CT肿瘤最大径、肿瘤位置、%FEV1和拟切除肺段类型)PSM后,两组各成功匹配43例患者。PSM后,与非重建组相比,重建组患者复杂肺段手术时间更短(155.77±30.17 min vs.212.94±66.49 min,P<0.001),术中出血量更少(46.00±25.94 ml vs.88.79±68.36 ml,P=0.002)。结论术前三维重建有助于提高单操作孔胸腔镜复杂肺段手术效率并减少术中出血。

Objective To evaluate the clinical value of 3D reconstruction in the single utility-port thoracoscopic segmentectomy of early stage NSCLC by propensity score matching(PSM).Methods We retrospectively analyzed clinical data of 150 early stage NSCLC patients undergoing single utilityport thoracoscopic segmentectomy.The patients were divided into reconstruction group(n=58)and nonreconstruction group(n=92)according to 3D reconstruction.PSM was performed on two groups to compare perioperative outcomes.Results Procedures were successfully completed on all patients,without perioperative death.In each group,43 patients were successfully matched after PSM on the basis of 8 confounding factors,age,gender,smoking status,BMI,maximum tumor diameter on CT,tumor location,%FEV1 and type of planned segmentectomy.After PSM,in complex segmentectomy,the patients in the reconstruction group had shorter operation time(155.77±30.17 vs.212.94±66.49min,P<0.001)and less blood loss(46.00±25.94 vs.88.79±68.36ml,P=0.002),compared with the non-reconstruction group.Conclusion Preoperative 3D reconstruction could help improve the efficiency of single utility-port thoracoscopic surgery for complex segmentectomy and reduce intraoperative bleeding.