经剑突单孔胸腔镜肺叶切除术治疗非小细胞肺癌的临床研究

Clinical study of single port thoracoscopic lobectomy via xiphoid process for non-small cell lung cancer

目的:观察经剑突单孔胸腔镜肺叶切除术治疗非小细胞肺癌的临床价值。方法:选取2020年6月至2022年5月手术治疗的121例非小细胞肺癌患者,其中53例患者经剑突行单孔胸腔镜肺叶切除术(剑突组),68例经肋间行单孔胸腔镜肺叶切除术(对照组)。观察并比较两组手术时间、置管时间、术中出血量、住院时间、疼痛评分、短期生存率、复发率等相关指标。结果:剑突组手术时间、置管时间、住院时间短于对照组,术中出血量少于对照组,疼痛评分低于对照组,差异有统计学意义(P<0.05)。术后24 h,两组血清可溶性主要组织相容性复合体Ⅰ类链相关蛋白A水平均较术前降低(P<0.05),剑突组低于对照组(P<0.05)。剑突组与对照组并发症总发生率分别为7.55%与16.18%,短期生存率分别为94.34%与91.18%,复发率分别为9.43%与10.29%,差异均无统计学意义(P>0.05)。结论:经剑突单孔胸腔镜肺叶切除术治疗非小细胞肺癌的效果较好,能降低患者疼痛程度、缩短康复进程。

Objective:To observe the clinical treatment value of subxiphoid single port video-assisted thoracoscopic surgery(SUVATS)in patients with non-small cell lung cancer(NSCLC).Methods:A total of 121 patients with NSCLC who underwent surgery from Jun.2020 to May 2022 were selected as the study objects,patients who underwent SUVATS were classified as the xiphisternum group(n=53),and those who underwent trans-intercostal single-port thoracoscopic lobectomy were classified as the control group(n=68).Operation time,catheterization time,intraoperative blood loss,hospital stay,pain score,short-term survival rate,and recurrence rate were observed and compared between the two groups.Results:Compared with the control group,the operation time,catheterization time and hospital stay in the xiphisternum group were significantly shorter,the intraoperative blood loss was fewer,and the pain score was lower(P<0.05).The level of serum soluble major histocompatibility complex class-Ⅰchain associated protein A in the xiphisternum group and the control group at 24 h after operation was significantly lower than that before operation(P<0.05),and that in the xiphisternum group was lower than that in the control group(P<0.05).In the xiphisternum group and control group,the total incidence of complications was 7.55%and 16.18%,the short-term survival rate was 94.34%and 91.18%,and the recurrence rate was 9.43%and 10.29%,respectively,there were no significant differences between the two groups(P>0.05).Conclusions:SUVATS has a good therapeutic effect for NSCLC,can reduce the pain degree of patients,and shorten the rehabilitation process.