单孔胸腔镜下肺段切除与肺叶切除治疗ⅠA期非小细胞肺癌的近期效果对比

Comparison of the short-term effects of single port thoracoscopic pulmonary lobectomy and segmental pulmonary resection in the treatment of stage IA non-small cell lung cancer

目的比较单孔胸腔镜下肺段切除与肺叶切除治疗ⅠA期非小细胞肺癌的近期临床效果。方法回顾性分析2020年1月—2021年1月本院收治的143例肺结节患者行单孔胸腔镜手术治疗的临床资料。根据患者手术方法的不同,将患者分成单孔胸腔镜下肺段切除组(肺段组,60例)和单孔胸腔镜下肺叶切除组(肺叶组,83例)两组,分析两组患者的临床资料。结果两组患者均顺利完成手术,组间手术时间、淋巴结清扫个数、淋巴结清扫组数、术中出血量、胸管留置时间、术后住院时间比较,差异均无统计学意义(P>0.05)。在术后并发症的比较中,肺叶组心律失常发生高于肺段组,差异具有统计学意义(P<0.05);肺漏气、乳糜胸及肺部感染的发生率比较,差异无统计学意义(P>0.05)。结论经过严格选择的部分IA期非小细胞肺癌患者,采用单孔VATS肺段切除术治疗是安全、有效的,值得胸外科医生在临床工作上推广应用。

Objective To compare the short-term clinical effects of segmental pulmonary resection and pulmonary lobectomy under single port thoracoscope in the treatment of stage IA non-small cell lung cancer.Methods The clinical data of 143 patients suffered with pulmonary nodules those were admitted to the first affiliated hospital of Wannan Medical College and underwent single port thoracoscopic surgery in the hospital from January 2020 to January 2021 were retrospectively analyzed.And according to the different surgical methods of the patients,the patients were divided into two groups,single port thoracoscopic segmentectomy group(Lung segment group,60 cases)and single port thoracoscopic pulmonary lobectomy group(Lung lobe group,83 cases),the clinical data of the two groups of patients were analyzed.Results Both groups of patients successfully completed the operation,and there were no significant difference in the operation time,the number of lymph node dissection,the number of lymph node dissection groups,the amount of intraoperative blood loss,chest tube indwelling time,and postoperative hospital stay between the two groups(P>0.05).In the comparison of postoperative complications,the incidence of arrhythmia in the lung lobe group was higher than that in the lung segment group,and the difference was statistically significant(P<0.05).However,there were no significant difference in the occurrence of pulmonary air leakage,chylothorax and lung infection between the two groups(P>0.05).Conclusions After rigorously selected patients with stage IA non-small cell lung cancer,single port VATS segmentectomy is safe and effective,and it is worthy of promotion and application by thoracic surgeons in clinical work.