单孔与双孔电视胸腔镜肺叶切除术治疗肺癌的临床疗效比较

Comparison of Clinical Efficacy of Single-port and Double-port Video-assisted Thoracoscopic Lobectomy in the Treatment of Lung Cancer

目的探讨单孔与双孔电视胸腔镜肺叶切除术治疗肺癌的临床疗效。方法随机选取2016年1月至2023年1月在武警北京总队医院接受胸腔镜肺叶切除术的患者,根据切除方案的不同分为双孔电视胸腔镜肺叶切除组(n=50,双孔组)和同期接受单孔电视胸腔镜肺叶切除组(n=50,单孔组)。对比手术指标、肺功能指标、并发症及相关检验指标。结果单孔组术中出血量、胸腔引流量,住院时间低于双孔组(P<0.05),手术操作时间高于双孔组;淋巴清扫个数、术前后肺功能差异无统计学意义(P>0.05)。单孔组并发症发生率低于双孔组(P<0.05);术前EGFR、TGF-α、IGA、IGM差异无统计学意义(P>0.05)。干预后双孔组EGFR、TGF-α高于单孔组,IGA、IGM低于单孔组(P<0.05)。结论2种方案对于淋巴清扫数量及术后肺功能恢复效果相近,但单孔手术操作的安全性更高,并发症发生率较低,降低炎性反应,利于术后恢复,具有积极临床使用价值。

Objective To investigate the clinical efficacy of single-port and double port video-assisted thoracoscopic lobectomy in the treatment of lung cancer.Methods Patients who underwent thoracoscopic lobectomy in Beijing Armed Police Corps Hospital from January 2016 to January 2023 were randomly selected and divided into two groups(n=50,double port group;n=50,single port group)according to different resection plans.The surgical indexes,pulmonary function indexes,complications and related test indexes were compared.Results The amount of intraoperative blood loss,thoracic drainage,hospital stay and operation time in the singleport group were lower than those in the double-port group(P<0.05),and the operation time was higher than that in the double-port group.There was no significant difference in the number of lymphatic dissection and pulmonary function before and after surgery(P>0.05).The complication rate of single-port group was lower than that of doubleport group(P<0.05).There was no significant difference in EGFR,TGF-α,IGA and IGM before operation(P>0.05).After intervention,EGFR and TGF-αin double-port group were higher than those in single-port group,IGA and IGM were lower than those in single-port group(P<0.05).Conclusion The two protocols have similar effects on the number of lymphatic clearance and postoperative pulmonary function recovery,but the single-port surgical operation is safer,with a lower complication rate,lower inflammatory reaction,and facilitates postoperative recovery,which is of positive clinical use value.