超声刀在行新辅助放疗后的中晚期非小细胞肺癌手术中的应用

Application of ultrasound knife in middle-late stage non-small cell lung cancer surgery after neoadjuvant radiotherapy

目的:观察超声刀在行新辅助放疗后的中晚期非小细胞肺癌手术中的临床应用价值。方法:同期使用超声刀(35例)和电刀(29例)行肺癌肺叶切除术,对比观察两组的手术时间、术中出血量、术后24 h胸腔引流量等指标。结果:所有病例均顺利完成手术,超声刀组平均手术时间(100.79±15.04)min,术中平均出血量(50.35±6.42)m L,术后24 h平均胸腔引流量(217.45±32.18)m L;电刀组分别为(95.26±16.59)min、(97.80±10.80)m L、(314.24±36.28)m L;两组比较平均手术时间差异无统计学意义(P>0.05),术中平均出血量和术后24 h平均胸腔引流量差异均有统计学意义(P<0.05)。术后无胸腔内出血二次手术及手术相关并发症。结论:超声刀在行新辅助放疗后的中晚期非小细胞肺癌手术中具有精确切割、损伤小、出血少、可以提高手术的安全性等优点,值得临床推广应用。

Objective:To observe the clinical application value of ultrasound knife in middle-late stage non-small cell lung cancer surgery after neoadjuvant radiotherapy.Methods:Ultrasound knife(35 cases) and electrotome(29 cases) were given for lung cancer lung resection at the same term.The operation time,intraoperative bleeding amount,postoperative 24 hours chest drainage and other indexes were compared.Results:All patients were successfully completed surgery.The average operation time of the ultrasound knife group was(100.79 ± 15.04)minutes;the intraoperative average bleeding amount was(50.35 ± 6.42)m L;postoperative 24 hours average chest drainage was(217.45±32.18)m L.The electrotome group was respectively(95.26±16.59)minutes,(97.80±10.80)m L,(314.24±36.28)m L.There was no statistically significant between the two groups in average operation time difference(P>0.05);there were statistically significant between the two groups in the intraoperative average bleeding amount and postoperative 24 hours average chest drainage difference(P<0.05).There was no chest hemorrhage secondary surgery and surgery related complications after operation.Conclusion:The ultrasound knife in middle-late stage non-small cell lung cancer surgery after neoadjuvant radiotherapy has the advantages of precise cutting,less damage and less bleeding,improving the surgery safety.It is worthy of clinical application.