单孔胸腔镜支气管袖状切除术与开胸支气管袖状切除术治疗中央型肺癌的疗效对比研究

A comparison study of efficacy of single-port thoracoscopic bronchial sleeve resection and thoracotomy bronchial sleeve resection in treatment of central lung cancer

目的对比单孔胸腔镜支气管袖状切除术和开胸支气管袖状切除术治疗中央型肺癌的可行性和安全性。方法回顾性分析2020年5月-2024年3月新疆医科大学附属肿瘤医院胸外科开展支气管袖状切除术的68例中央型肺癌患者,按照手术方式分为观察组(进行单孔胸腔镜支气管袖状切除术)32例,对照组(实施传统开胸支气管袖状切除术)36例。比较两组一般资料,包括:淋巴结清扫数目、手术时间、术中出血量、术后引流量、术后疼痛评分、术后拔管时间、术后住院时间、术后并发症情况。结果所有患者手术均顺利结束,均无支气管断端残留和围术期死亡。与对照组比较,观察组患者术中出血量、术后引流量减少;术后拔管时间、术后并发症发生率及术后住院天数缩短、术后疼痛评分降低,两组之间比较有统计学意义(P<0.05)。两组之间手术时间和术中淋巴结清扫情况比较,差异无统计学意义(P>0.05)。结论与传统开胸支气管袖状切除术相比,单孔胸腔镜支气管袖状切除术治疗中央型肺癌具有术中创伤小,术后恢复快,近期疗效可靠等优点,具有临床推广意义。

Objective To compare the feasibility and safety of single-port thoracoscopic bronchial sleeve resection and thoracotomy for central lung cancer.Methods A retrospective analysis was conducted on 68 patients with central lung cancer who underwent bronchial sleeve resection in the hospital from May 2020 to March 2024.The patients were divided intoobservation group(32 cases underwent single port thoracoscopic bronchial sleeve resection)and control group(36 cases underwent traditional open chest bronchial sleeve resection)according to the surgical method.Compare 2 sets of general information,including the number of lymph node dissections,surgical time,intraoperative blood loss,postoperative drainage volume,postoperative pain score,postoperative extubation time,postoperative hospital stay and postoperative complications.Results All patient'surgeries were successfully completed without any residual bron-chial stump or perioperative mortality.Compared with control group,the observation group showed a de-crease in intraoperative bleeding and postoperative drainage volume.The postoperative extubation time,incidence of postoperative complications,shortened hospital stay,and reduced postoperative pain score were statistically significant between the 2 groups(P<0.05).There was no statistically significant differ-ence in surgical time and intraoperative lymph node dissection between the 2 groups(P>0.05).Conclu-sion Compared with traditional open-chest bronchial sleeve resection,single-port thoracoscopic bronchial sleeve resection for central lung cancer has the advantages of less trauma during operation,faster postoper-ative recovery and reliable short-term curative effect.