单操作孔及纯单孔胸腔镜肺叶切除术对NSCLC患者康复进程及预后情况的影响比较

Comparison of the Effects of Single Utility Port and Pure Single Port Thoracoscopic Lobectomy on the Rehabilitation Process and Prognosis of Patients with NSCLC

目的:比较非小细胞型肺癌(NSCLC)患者应用单操作孔及纯单孔胸腔镜肺叶切除术对康复进程及预后情况的影响。方法:回顾性分析北京大学首钢医院2020年1月-2022年1月收治的94例NSCLC患者,根据手术方式分成两组,单操作孔组(n=47)行单操作孔胸腔镜肺叶切除术治疗,纯单孔组(n=47)行纯单孔胸腔镜肺叶切除术治疗,比较两组的康复进程及预后情况。结果:两组引流管放置时间、淋巴结清扫数量比较,差异无统计学意义(P>0.05)。纯单孔组手术时间长于单操作孔组,住院时间短于单操作孔组,术中出血量少于单操作孔组,差异均有统计学意义(P<0.05)。两组术后并发症发生率比较,差异无统计学意义(P>0.05)。两组术后6 h时VAS评分比较,差异无统计学意义(P>0.05)。两组术后24 h时VAS评分均低于术后6 h时,且纯单孔组低于单操作孔组,差异有统计学意义(P<0.05)。结论:NSCLC患者应用纯单孔胸腔镜肺叶切除术可保证效果,且减轻创伤,是一种优秀的手术方法。

Objective: To compare the effects of single utility port and pure single port thoracoscopic lobectomy on the rehabilitation and prognosis of patients with non-small cell lung cancer(NSCLC). Method: Retrospective analysis of 94 NSCLC patients admitted to Peking University Shougang Hospital from January 2020 to January 2022 was conducted. They were divided into two groups according to the surgical methods. The single utility port group(n=47) underwent single utility port thoracoscopic lobectomy, and the pure single port group(n=47) underwent pure single port thoracoscopic lobectomy. The rehabilitation and prognosis of the two groups were compared.Result: There were no significant differences in drainage tube placement time and number of lymph nodes dissected between the two groups(P>0.05). The operation time in the pure single port group was longer than that in the single utility port group, the hospital stay was shorter than that in the single utility port group, and the intraoperative blood loss was less than that in the single utility port group, and the differences were statistically significant(P<0.05). There was no significant difference in the postoperative complication rate between the two groups(P>0.05). There was no significant difference in VAS score between the two groups at 6 hours after operation(P>0.05).The VAS scores at 24 hours after operation in the two groups were lower than those 6 hours after operation, and the pure single port group was lower than that in the single utility port group, the difference was statistically significant(P<0.05). Conclusion: Pure single port thoracoscopic lobectomy for NSCLC patients can ensure the effect and reduce the trauma, which is an excellent surgical method.