模式化单操作孔胸腔镜行肺癌根治术的临床疗效观察

Clinical curative effect of radical resection of lung cancer under modular single-port VATS

目的探讨模式化单操作孔胸腔镜行肺癌根治术的临床疗效。方法选取黄骅市人民医院收治的肺癌患者120例,随机分为研究组和对照组各60例,研究组予以模式化单操作孔VATS治疗,对照组予以三孔VATS治疗。比较两组患者手术相关指标,包括手术时间、术中出血量、淋巴结清扫数目、拔除引流管时间、下床活动时间和住院时间,视觉模拟评分(VAS);血清指标如基质金属蛋白酶9(MMP-9)、癌胚抗原(CEA)、淀粉样蛋白A(SAA)、肺癌治疗功能评价量表(FACT-L)评分以及手术后并发症发生情况。结果研究组术中出血量、拔除引流管时间、下床活动时间和住院时间均低于对照组,差异有统计学意义(P<0.05),两组手术时间和淋巴结清扫数目比较差异无统计学意义(t=1.085、1.308,P>0.05);两组术后第3 d VAS评分低于术后第1 d,且研究组术后第3 d VAS评分低于对照组,差异有统计学意义(P<0.05);手术后,两组MMP-9、CEA和SAA水平低于术前,且研究组MMP-9、CEA和SAA水平低于对照组,差异有统计学意义(P<0.05);手术后,两组FACT-L各维度评分和总分均高于术前,且研究组FACT-L各维度评分和总分均高于对照组,差异有统计学意义(P<0.05);手术后,对照组中有8例患者出现并发症,总发生率为13.33%,研究组有5例患者出现并发症,总发生率为8.33%,两组并发症总发生率差异无统计学意义(χ^(2)=0.776,P>0.05)。结论模式化单操作孔VATS可以降低手术创伤和术后疼痛,促进恢复,抑制炎症反应,降低肿瘤标志物水平,改善生活质量,安全性好。

Objective To explore the clinical curative effect of radical resection of lung cancer under modular single-port video-assisted thoracoscopic surgery(VATS).Methods A total of 120 patients with lung cancer admitted Huanghua People’s Hospital were enrolled and randomly divided into the study group and the control group,60 cases in each group.The study group was treated with modular single-port VATS,while control group was treated with three-port VATS.The surgery-related indexes(operating time,intraoperative blood loss,number of lymph node dissection,extubation time of drainage tube,leaving bedtime,hospitalization time),scores of visual analogue scale(VAS),serum indexes such as matrix metalloproteinase-9(MMP-9),carcinoembryonic antigen(CEA),serum amyloid A(SAA),scores of functional assessment of cancer therapy-lung cancer(FACT-L)and occurrence of postoperative complications were compared between the two groups.Results The intraoperative blood loss,extubation time of drainage tube,leaving bedtime and hospitalization time in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The difference in operation time and number of lymph node dissection between the two groups was not statistically significant(t=1.085,1.308,P>0.05).The VAS score on the 3 rd postoperative day in the two groups was lower than that on the 1 st postoperative day,and the VAS score on the 3 rd postoperative day in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).After surgery,the scores and total scores of FACT-L in both groups were increased,which were higher in the study group than those in the control group,and the differences were statistically significant(P<0.05).After surgery,8 patients in the control group developed complications,with a total incidence of 13.33%,while 5 patients in the study group developed complications,with a total incidence of 8.33%.There was no significant difference in the total incidence of complications between the two groups(χ^(2)=0.776,P>0.05).Conclusion Modular single-port VATS can reduce surgical trauma and postoperative pain,promote recovery,inhibit inflammation response,reduce levels of tumor markers,and improve quality of life in patients,with good safety.