三维重建技术在早期非小细胞肺癌患者单孔胸腔镜肺段切除术中的应用

Application of three-dimensional reconstruction technique in single-hole thoracoscopy pulmonary segmentectomy for early non-small cell lung cancer

目的观察三维重建技术在早期非小细胞肺癌(NSCLC)患者单孔胸腔镜肺段切除术中的应用效果。方法前瞻性研究。抽取2020年1月至2022年12月安阳市人民医院收治的90例行单孔胸腔镜肺段切除术治疗的早期NSCLC患者纳入此研究。采用随机数字表法将其分为对照组与观察组,每组45例。对照组实施常规膨胀萎陷法单孔胸腔镜肺段切除术治疗,观察组实施基于三维重建个体化单孔胸腔镜肺段切除术治疗。比较两组围术期指标;比较两组术前、术后7 d肺功能指标[呼气流量峰值(PEF)、第1秒用力呼气容积(FEV1)、用力肺活量(FVC)];比较两组手术并发症发生情况。结果观察组切缘宽度大于对照组,术中出血量、总引流量少于对照组,手术时间、胸管留置时间及住院时间均短于对照组(P均<0.05);术后7 d,两组PEF、FEV1、FVC均较术前降低,但观察组上述指标均高于对照组(P均<0.05)。观察组手术并发症总发生率(4.44%,2/45)低于对照组(20.00%,9/45),P<0.05。结论三维重建技术应用于早期NSCLC单孔胸腔镜肺段切除术中,有助于肺段精准切除,减少术中出血量,缩短手术时间,降低手术并发症发生率。

Objective To investigate the application effect of three-dimensional reconstruction in single-hole thoracoscopy pulmonary segmentectomy for early non-small cell lung cancer(NSCLC).Methods This prospective study included 90 patients with early NSCLC who underwent single-hole thoracoscopy pulmonary segmentectomy in Anyang People’s Hospital from January 2020 to December 2022.They were divided into the control group and the observation group by random number table method,with 45 cases in each group.The control group was treated by conventional swelling collapse combined with single-hole thoracoscopy segmentectomy,while the observation group was treated by individualized single-hole thoracoscopy segmentectomy combined with three-dimensional reconstruction.The perioperative indexes of the two groups were compared.Pulmonary function indexes,including peak expiratory flow(PEF),forced expiratory volume in 1 second(FEV1)and forced vital capacity(FVC)were compared between the two groups before and 7 days after operation;and incidence of surgical complications of the two groups were compared.Results The incision margin width of the observation group was larger than that of the control group(P<0.05);the intraoperative blood loss and total drainage volume of the observation group were less than those of the control group(P<0.05);while the operation time,chest tube indwelling time and hospital stay of the observation group were shorter than those of the control group(P<0.05).Seven days after surgery,the PEF,FEV1 and FVC in both groups were lower than those before surgery,but the above indicators in the observation group were higher than those in the control group(all P<0.05).The total incidence of surgical complications in the observation group(4.44%,2/45)was lower than that in the control group(20.00%,9/45),P<0.05.Conclusions The application of three-dimensional reconstruction technology in single-hole thoracoscopy pulmonary segmentectomy for early NSCLC is helpful to accurate pulmonary segmentectomy,reduce intraoperative bleeding,shorten the operation time,and reduce the incidence of surgical complications.