单孔胸腔镜肺叶切除术治疗早期周围型非小细胞肺癌疗效研究
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摘要
目的探讨单孔胸腔镜肺叶切除术在早期周围型非小细胞肺癌治疗中的疗效。方法回顾分析2016年10月至2018年10月在我院行VATS肺叶切除术的65例肺癌患者资料,分为两组(单孔VATS组28例;三孔VATS组37例),对比观察两组手术时间、术中出血量、淋巴结清扫个数、术后引流液总量、术后胸管留置时间、术后住院时间、术后肺部感染、肺漏气、肺不张等呼吸系统并发症发生率、心律失常发生率,术后第1、3、5天VAS评分等指标。结果两组均顺利完成手术,单孔组术后第1、3、5天VAS评分低于三孔组术后VAS评分,其余对比指标两组间无明显差异(P>0.05)。结论单孔VATS术后疼痛感轻,更利于患者快速康复,值得临床推广应用。
Objective To investigate the efficacy of single-port thoracoscopic lobectomy in the treatment of early peripheral nonsmall cell lung cancer. Methods A retrospective analysis of 65 patients with lung cancer who undergone VATS lobectomy in our hospital from Oct 2016 to Oct 2018, divided into two groups(28 patients in single-port VATS group, 37 patients in three-port VATS group),compared the operation time, intraoperative blood loss, lymph node dissection, total postoperative drainage fluid, postoperative chest tube indwelling time, postoperative hospital stay, the incidence of respiratory complications(postoperative pulmonary infection, lung leak, atelectasis), the incidence of arrhythmia, VAS scores on the 1 st, 3 rd, and 5 th day after surgery and other indicators of two groups. Results The operation was successfully completed in both groups. The VAS scores on the 1 st, 3 rd, and 5 th day after operation in the single-port groupwere lower than those in the three-port group, but there was no significant difference between the other two groups. Conclusion The single-port VATS has a light pain, which is more conducive to rapid recovery. It is worthy of clinical application.
Objective To investigate the efficacy of single-port thoracoscopic lobectomy in the treatment of early peripheral nonsmall cell lung cancer. Methods A retrospective analysis of 65 patients with lung cancer who undergone VATS lobectomy in our hospital from Oct 2016 to Oct 2018, divided into two groups(28 patients in single-port VATS group, 37 patients in three-port VATS group),compared the operation time, intraoperative blood loss, lymph node dissection, total postoperative drainage fluid, postoperative chest tube indwelling time, postoperative hospital stay, the incidence of respiratory complications(postoperative pulmonary infection, lung leak, atelectasis), the incidence of arrhythmia, VAS scores on the 1 st, 3 rd, and 5 th day after surgery and other indicators of two groups. Results The operation was successfully completed in both groups. The VAS scores on the 1 st, 3 rd, and 5 th day after operation in the single-port groupwere lower than those in the three-port group, but there was no significant difference between the other two groups. Conclusion The single-port VATS has a light pain, which is more conducive to rapid recovery. It is worthy of clinical application.
引文
[1]支修益,石远凯,于金明.中国原发性肺癌诊疗规范(2015年版)[J].中华肿瘤杂志,2015,37(1):67-78.
[2] Nwogu C E, D’Cunha J, Pang H, et al. VATS Lobectomy Has Better Preoperative Outcomes Than Open Lobectomy:CALGB 31001, an Ancillary Analysis of CALGB 140202(Alliance)[J]. Annals of Thoracic Surgery,2015,99(2):399-405.
[3]王学中,刘志广,刘平.单孔与传统”三孔”法胸腔镜手术治疗肺癌的临床疗效比较[J].实用癌症杂志,2018,33(3):470-474.
[4]韦海涛,李丽,王作培,等.单孔与三孔胸腔镜下肺癌根治术临床疗效的对比分析[J].中华胸心血管外科杂志,2016,32(6):356-358.
[5]胡成广,马殿松,郑康,等.单孔胸腔镜肺叶切除治疗肺癌192例报告[J].中国微创外科杂志,2018,38(5):394-396.
[6]丁香园.2015版美国国立综合癌症网络(NCCN)指南:非小细胞肺癌更新要点[J].实用心脑肺血管病杂志,2015,(2):55.
[7] Sax H, Bloemberg G, Hasse B, et al. Prolonged Outbreak of Mycobacterium chimaera Infection After Open-Chest Heart Surgery[J]. Clinical Infectious Diseases An Official Publication of the Infectious Diseases Society of America,2015,61(1):67.
[8]谢冬,陈昶,朱余明,等.单孔胸腔镜手术的现状与展望[J].中华腔镜外科杂志(电子版),2016,9(2):73-76.
[9]谢东,姜格宁,赵佳平,等.单孔全胸腔镜治疗中央型肺部肿瘤5例[J].中华胸心血管外科杂志.2015,31(3):177-178.
[2] Nwogu C E, D’Cunha J, Pang H, et al. VATS Lobectomy Has Better Preoperative Outcomes Than Open Lobectomy:CALGB 31001, an Ancillary Analysis of CALGB 140202(Alliance)[J]. Annals of Thoracic Surgery,2015,99(2):399-405.
[3]王学中,刘志广,刘平.单孔与传统”三孔”法胸腔镜手术治疗肺癌的临床疗效比较[J].实用癌症杂志,2018,33(3):470-474.
[4]韦海涛,李丽,王作培,等.单孔与三孔胸腔镜下肺癌根治术临床疗效的对比分析[J].中华胸心血管外科杂志,2016,32(6):356-358.
[5]胡成广,马殿松,郑康,等.单孔胸腔镜肺叶切除治疗肺癌192例报告[J].中国微创外科杂志,2018,38(5):394-396.
[6]丁香园.2015版美国国立综合癌症网络(NCCN)指南:非小细胞肺癌更新要点[J].实用心脑肺血管病杂志,2015,(2):55.
[7] Sax H, Bloemberg G, Hasse B, et al. Prolonged Outbreak of Mycobacterium chimaera Infection After Open-Chest Heart Surgery[J]. Clinical Infectious Diseases An Official Publication of the Infectious Diseases Society of America,2015,61(1):67.
[8]谢冬,陈昶,朱余明,等.单孔胸腔镜手术的现状与展望[J].中华腔镜外科杂志(电子版),2016,9(2):73-76.
[9]谢东,姜格宁,赵佳平,等.单孔全胸腔镜治疗中央型肺部肿瘤5例[J].中华胸心血管外科杂志.2015,31(3):177-178.