不同方式胸腔镜肺癌手术应用于早期肺癌的临床疗效

The clinical effects of different video-assisted thoracoscopic lung cancer surgery in the treatment of early stage lung cancer

目的探析不同电视辅助胸腔镜(VATS)肺段切除术应用于早期肺癌临床效果及对术后并发症发生率影响。方法回顾性分析2017年3月—2021年3月本院收治的行胸腔镜下肺段切除术的152例早期肺癌患者的临床资料,根据选择术式差异分为观察组(72例)和对照组(80例)。对照组实施多孔VATS肺段切除术,观察组实施单孔VATS肺段切除术。对比两组围手术期疗效及质量指标、预后质量(肺癌治疗功能性量表(FAcT-L))、术后并发症发生率、疼痛程度(视觉模拟量表(VAS))。结果观察组住院时间、术后1天、3天疼痛评分均明显低于对照组(P<0.05),而手术时间长于对照组(P<0.05);两组治疗前FAcT-L评分无统计学差异(P>0.05),治疗后两组FAcT-L评分均明显升高,且观察组FAcT-L评分高于对照组(P<0.05)。结论单孔VATS肺段切除术应用于早期肺癌临床效果显著,具有与多孔VATS肺段切除术相当的淋巴结清扫效果及较少并发症发生率,可有效改善术后疼痛评分,提高患者生存质量及康复效率,值得临床推广。

Objective To explore the clinical effects of different video-assisted thoracoscopic(VATS)segmentectomy for early stage lung cancer and its influence on postoperative complications.Methods A total of 152 patients those were suffered with early-stage lung cancer and underwent thoracoscopic segmentectomy in our hospitalfrom March 2017 to March 2021 were enrolled as study subjects,and the clinical data of them were retrospectively analyzed.According to the variance of operation method they were divided into observation group(72 cases)and control group(80 cases).Patients in the control group underwent multi-hole VATS segmentectomy,while patients in the observation group underwent single-hole VATS segmentectomy.The perioperative efficacy and quality indicators,prognosis quality(functional assessment of cancer therapy-lung,FAcT-L),postoperative complication rate and pain degree(visual analog scale,VAS)were compared between the two groups.Results The hospital stay,and pain scores at 1 stday and 3 rdday after operation in the observation group were significantly lower than those in the control group(P<0.05),however,the operation time were longer than that of control group(P<0.05).There was no significant difference between the two groups in FAcT-l score before treatment(P>0.05).FAcT-l scores in both two groups increased significantly after treatment,and FAcT-l score in observation group was higher than that in control group(P<0.05).Conclusions Single-hole VATS segmentectomy has a significant clinical effect in early stage lung cancer.It has the same lymph node dissection effect as multi-hole VATS segmentectomyand achieves less complication rate.It could effectively improve postoperative pain scores,improve patients’quality of life and rehabilitation,it is worthy of clinical promotion.