胸腔镜肺癌根治术中不同纵隔淋巴结清扫方法的安全性评估

Safety evaluation of different methods of mediastinal lymph node dissection in thoracoscopic radical resection of lung cancer

目的探讨胸腔镜肺癌根治术中采取不同纵隔淋巴结清扫方法的安全性。方法回顾性分析50例肺癌患者的临床资料,根据膈淋巴结清扫方式不同分为观察组与对照组,每组25例。所有患者均进行肺癌根治术与纵隔淋巴结清扫术(LND),对照组采取传统清扫方式,观察组采取改良清扫方式。对比两组手术指标,疼痛程度,并发症发生情况。结果观察组的淋巴结清扫数目(5.72±1.02)枚、术中出血量(55.36±2.60)ml均少于对照组的(7.48±1.12)枚、(62.72±1.81)ml,差异有统计学意义(P<0.05)。观察组视觉模拟评分法(VAS)评分为(5.04±0.89)分,低于对照组的(7.16±0.80)分,差异有统计学意义(P<0.05)。观察组肺部感染、淋巴漏发生率分别为4.00%、0,低于对照组的32.00%、24.00%,差异有统计学意义(P<0.05)。两组患者的水肿发生率对比差异无统计学意义(P>0.05)。结论胸腔镜肺癌根治术中改良淋巴结清扫方式,可改善患者的术后疼痛问题,降低并发症风险。

Objective To discuss the safety of different methods of mediastinal lymph node dissection in thoracoscopic radical resection of lung cancer.Methods A total of of 50 patients with lung cancer were retrospectively analyzed and divided into observation group and control group according to different methods of mediastinal lymph node dissection,with 25 cases in each group.All patients underwent radical resection of lung cancer and mediastinal lymph node dissection(LND).The control group received conventional dissection,and the observation group received modified lymph node dissection.The surgical indicators,pain level,and complications were compared between the two groups.Results The number of lymph nodes dissection of(5.72±1.02)nodes and intraoperative blood loss of(55.36±2.60)ml in the observation group were less than those of(7.48±1.12)nodes and(62.72±1.81)ml in the control group,and the differences were statistically significant(P<0.05).The visual analogue scale(VAS)score of the observation group was(5.04±0.89)points,which was lower than that of(7.16±0.80)points of the control group,and the difference was statistically significant(P<0.05).The incidence of pulmonary infection and lymphatic fistula in the observation group were 4.00%and 0,which were lower than those of 32.00%and 24.00%in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of edema between the two groups(P>0.05).Conclusion Modified lymph node dissection in thoracoscopic radical resection of lung cancer surgery can improve postoperative pain and reduce the risk of adverse reactions.