全胸腔镜肺叶切除术治疗非小细胞肺癌的效果及对肺功能的影响

Effect of Total Thoracoscopic Lobectomy in the Treatment of Non-small Cell Lung Cancer and Its Impact on Lung Function

目的:探讨全胸腔镜肺叶切除术治疗非小细胞肺癌(NSCLC)的效果及对肺功能的影响。方法:回顾性分析2017年1月-2021年12月厦门市海沧医院胸外科收治并行肺叶切除术的80例NSCLC患者。按照手术方式的不同分为对照组和观察组,每组40例。对照组采取传统开胸肺叶切除术,观察组采取全胸腔镜肺叶切除术。比较两组围手术期相关指标(手术时长、术中出血量、术后引流量、淋巴清扫个数、淋巴清扫站数及术后住院时长)、术后并发症发生情况、术后疼痛情况[数字疼痛评分法(NRS)]及肺功能指标[最大通气量(MVV)及第1秒用力呼气容积(FEV)]的变化。结果:观察组术中出血量、术后引流量均少于对照组(P<0.05),术后住院时长短于对照组(P<0.05);两组淋巴清扫个数及淋巴清扫站数比较,差异无统计学意义(P>0.05)。观察组术后总并发症发生率低于对照组(P<0.05)。观察组术后1、3 d的NRS评分均低于对照组(P<0.05)。出院时,两组MVV及FEV均下降(P<0.05),但观察组高于对照组(P<0.05)。结论:全胸腔镜肺叶切除术治疗NSCLC相较于传统开胸手术,具有术中出血量少、术后引流量少、患者痛苦小和肺功能恢复快等临床优势。

Objective:To investigate the efficacy of total thoracoscopic lobectomy in the treatment of non-small cell lung cancer (NSCLC) and its impact on lung function.Method:A retrospective analysis of 80 patients with NSCLC who underwent lobectomy in Department of Cardiothoracic Surgery in Xiamen Haicang Hospital from January 2017 to December 2021.According to the different surgical methods,they were divided into control group and observation group,40 cases in each group.The control group received traditional thoracotomy lobectomy,and the observation group received total thoracoscopic lobectomy.The perioperative related indexes (operation time,intraoperative blood loss,postoperative drainage,number of lymph node dissection,number of lymph node dissection stations and postoperative hospital stay),postoperative complications,postoperative pain[numerical rating scale (NRS)]and lung function indexes[maximum ventilation volume (MVV) and forced expiratory volume in one second (FEV)]were compared between the two groups.Result:The intraoperative blood loss,postoperative drainage volume in the observation group were less than those in the control group (P<0.05),and postoperative hospital stay in the observation group was shorter than that in the control group (P<0.05).There were no significant differences in the number of lymph node dissection and lymph node dissection stations between the two groups (P>0.05).The total incidence of postoperative complications in the observation group was lower than that in the control group (P<0.05).The NRS scores in the observation group were lower than those in the control group at 1 day and 3 days after operation (P<0.05).At discharge,MVV and FEVdecreased in both groups (P<0.05),but the observation group were higher than those in the control group (P<0.05).Conclusion:Compared with traditional thoracotomy,total thoracoscopic lobectomy in the treatment of NSCLC has the clinical advantages of less intraoperative bleeding,less postoperative drainage,less pain and rapid recovery of lung function.