单孔胸腔镜肺叶切除术治疗肺癌近期疗效的病例对照研究  

The short-term efficacy of uniportal thoracoscopic lobectomy for lung cancer: A case control study

作　　者：潘雪峰 王金栋 PAN Xuefeng;WANG Jindong(Department of Thoracic Surgery,Xuzhou Clinical School of Xuzhou Medical University,Xuzhou,221004,Jiangsu,P.R.China;Department of Thoracic Surgery,Xuzhou No.1People's Hospital,Xuzhou Medical University,Xuzhou,221004,Jiangsu,P.R.China)

机构地区：[1]徐州医科大学徐州临床学院,江苏徐州221004 [2]徐州医科大学附属徐州市立医院胸外科,江苏徐州221004

出　　处：《中国胸心血管外科临床杂志》2018年第12期1068-1072,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：徐州市科技计划项目(KC16SH102)

摘　　要：目的探讨单孔胸腔镜(uniportal video-assisted thoracic surgery,U-VATS)肺叶切除术治疗肺癌的理念和近期疗效。方法回顾性分析我科同一术者在熟练掌握U-VATS肺叶切除并淋巴结清扫术后,2016年4月至2017年2月开展的50例[男40例、女10例,年龄(61.4±6.6)岁]常规U-VATS与11例单向式U-VATS肺叶切除术患者资料,与同期60例[男45例、女15例,年龄(59.2±9.7)岁]多孔胸腔镜(multiple-portal VATS,MVATS)肺叶切除术进行比较。结果 U-VATS和M-VATS组的患者年龄、性别、体重指数、术前合并症与肿瘤大小差异无统计学意义(P>0.05)。两组均无手术死亡或中转开胸。患者手术时间、术中出血量、清扫淋巴结个数、术后胸管引流时间、住院时间等差异无统计学意义(P>0.05)。U-VATS组患者术后12 h疼痛评分较M-VATS组显著降低(3.2 vs. 4.3,P=0.04)。亚组分析提示,11例单向式U-VATS的手术时间较常规U-VATS与M-VATS均显著缩短(76.4 min vs. 125.8 min vs. 105.6 min,P<0.05),但病例不足,不作进一步统计分析。结论 U-VATS肺叶切除术治疗肺癌的近期疗效不劣于M-VATS,同时单向式U-VATS肺叶切除术是可行的,可缩短手术时间。Objective To investigate the optimal procedure and short-term efficacy ofuniportal video-assisted thoracic surgery(U-VATS)lobectomy for lung cancer.MethodsThe clinical data of61patients who underwent lobectomy using U-VATS by the same surgeon between April2016and February2017were retrospectively analyzed. There were50patients(40males and10females,aged61.4+6.6years)with conventional procedure.And there were60patients(45males and15females,aged59.2±9.7years)utilizing multiportal thoracoscopic surgery(M-VATS) during this period.ResultsThe baseline characteristics in both groups such as age,gender,body mass index, comorbidity and tumor size were comparable(P>0.05).There was no postoperative mortality or conversion to thoracotomy in the study.The parameters such as operative time,blood loss,harvested lymph nodes,duration of chest tube drainage,and length of postoperative hospital stay were similar in both groups(P>0.05).However,there was a statistical difference in pain score at12h after surgery in favor of the U-VATS approach(3.2vs.4.3,P=0.04).Moreover, subgroup analysis indicated that the operation time using single-direction U-VATS was noticeably shorter than that in both conventional U-VATS and M-VATS(76.4min vs.125.8min vs.105.6min,P<0.05).However,further analysis was not performed because of small sample.ConclusionThe short-term efficacy of U-VATS lobectomy for lung cancer is noninferior to M-VATS,meanwhile,single-direction U-VATS lobectomy is feasible followed by shortened operative time.

关 键 词：单孔 单向式 胸腔镜 肺叶切除术 

分 类 号：R734.2[医药卫生—肿瘤]