单孔与三孔胸腔镜下肺叶切除术治疗周围型肺癌的临床研究  

Clinical Research of the Treatment in Peripheral Lung Cancer by Single-PortVATS and Three-Port VATS

作　　者：陈科[1] 黄海涛[1] 陈少慕[1] 马海涛[1] 

机构地区：[1]苏州大学附属第一医院胸外科,江苏苏州215006

出　　处：《中国血液流变学杂志》2017年第1期68-71,80,共5页Chinese Journal of Hemorheology

基　　金：江苏省科技项目（BY2015039-01）

摘　　要：目的 回顾性分析比较单孔胸腔镜下肺叶切除术与常规三孔胸腔镜术式的临床疗效,为早期周围型肺癌微创手术方式的选择提供参考.方法 选取苏州大学附属第一医院胸外科2016年1月—2016年12月周围型肺癌手术病例118例,按手术方式分为单孔手术组与三孔手术组,比较两组手术时间、淋巴结清扫数目、术中失血量、胸管引流量、术后置管天数、术后住院天数、围手术期并发症发生率、术后疼痛评分等指标的差异.结果 两组患者在性别、年龄上差异无统计学意义（P〉0.05）;单孔手术组与三孔手术组淋巴结清扫数目[（12.89±2.24）个vs（13.37±1.79）个]、术中失血量[（148.11±41.56）mL vs（158.77±45.05）mL]、术后胸管总引流量[（708.30±163.21）mL vs（762.44±170.92）mL]、术后胸管置管时间[（4.19±1.35）d vs（4.43±1.56）d]、术后住院天数[（6.96±1.62）d vs（7.34±1.75）d]、围术期并发症发生率（15.1％vs 15.4％）差异均无统计学意义（P〉0.05）.单孔手术组与三孔手术组手术时间[（142.83±29.43）min vs（129.08±30.40）min]、术后24 h疼痛评分[（4.85±1.63）分vs（5.95±1.86）分]、术后72 h疼痛评分[（1.54±1.14）分vs（2.20±1.18）分],差异有统计学意义（P〈0.05）.结论 单孔肺叶切除术治疗早期周围型肺癌可以达到与传统＂三孔法＂腔镜肺叶切除术相同的效果,而且在术后疼痛方面要优于常规＂三孔法＂术式,是一种有发展前途的手术方式.Objective To retrospectively analyze and compare the clinical effects between single-port VATS and three-port VATS lobectomy for patients with lung cancer, provide reference in the choice of early peripheral lung cancer minimal invasive thoracic surgery methods. Methods We retrospectively analyzed the clinical data of 118 patients with peripheral lung cancer who underwent VATS lobectomy from January 2016 to December 2016 in the First Affiliated Hospital of Soochow University. According to different surgical mode, they were divided into single-port and three-port VATS groups. The clinical outcomes including operation time, lymph node dissection number, intraoperative blood loss, pleural canals drainage, pleural canals duration time, postoperative hospital stay, perioperative period postoperative complications and degree of chest pain. Results There was no difference in sex and age （P〉0.05）. There was no statistical difference in lymph node dissection number [（12.89±2.24） vs. （13.37±1.79）], intraoperative blood loss [（148.11±41.56） mL vs. （158.77±45.05） mL], pleural canals drainage [（708.30±163.21） mL vs. （762.44±170.92） mL], pleural canals duration time [（4.19±1.35） d vs. （4.43±1.56） d],postoperative hospital stay [（6.96±1.62） d vs. （7.34±1.75） d], perioperative period postoperative complications rate （15.1% vs. 15.4%） between the two groups （P〉0.05）. There were statistical differences in operation time [（142.83±29.43） min vs. （129.08±30.40） min], degree of chest pain within 24 h after operation [（4.85±1.63） vs. （5.95±1.86）] and degree of chest pain within 72 h after operation [（1.54±1.14） vs. （2.20±1.18）] between the two groups （P〈0.05）. Conclusion Single-port VATS can reach the same curative effect as the traditional three-port VATS in early peripheral lung cancer, and is superior to three-port VATS in postoperative pain. Single-port VATS is a very promising operative type.

关 键 词：周围型肺癌 单孔胸腔镜 三孔胸腔镜 肺叶切除术 淋巴结清扫 

分 类 号：R655.3[医药卫生—外科学]