胸腔镜单操作孔与多操作孔肺叶切除术治疗周围型肺癌效果比较  

Efficacy comparison of single utility port and multiple utility ports thoracoscopic iobectomy for peripheral lung cancer

作　　者：胡成广[1] 廉建红[2] 郭石平[2] 马殿松 郑康[1] 刘冠华[1] 李志龙[1] 马炎炎 赵艳丽[1] 

机构地区：[1]山西医科大学附属肿瘤医院山西省肿瘤医院特需病房,太原030013 [2]山西医科大学附属肿瘤医院山西省肿瘤医院胸外二科,太原030013

出　　处：《肿瘤研究与临床》2018年第1期38-42,共5页Cancer Research and Clinic

摘　　要：目的 通过对比胸腔镜单操作孔与多操作孔肺叶切除术治疗周围型肺癌的效果,探讨单操作孔胸腔镜肺叶切除术的手术技巧、优劣性和可行性.方法 回顾性分析2011年7月至2014年11月在山西省肿瘤医院接受胸腔镜肺叶切除术的Ⅰ～Ⅱ期周围型肺癌223例,其中单操作孔肺叶切除78例（单操作孔组）,两操作孔或三操作孔肺叶切除145例（多操作孔组）.比较两组的手术时间、术中出血量、胸管引流量、术后住院时间、纵隔淋巴结清扫组数、淋巴结清扫数量、中转开胸率、术后并发症发生率、术后2年生存率及2年无瘤生存率等.结果 两组患者均无围术期死亡,单操作孔组与多操作孔组手术时间[（157.4±13.6）min比（151.3±23.2）min]、术中出血量[（180.77±59.97）ml比（171.31±77.51）ml]、胸管引流量[（370.26±146.09）ml比（351.17±159.07）ml]、淋巴结清扫组数[（4.29±0.65）组比（4.21±0.73）组]、淋巴结清扫数量[（11.50±2.30）枚比（11.04±2.29）枚]、中转开胸发生率[5.13％（4/78）比4.83％（7/145）]、术后并发症发生率[17.95％（14/78）比15.86％（23/145）]、术后住院时间[（8.74±0.51）d比（9.48±0.63）d]、2年生存率[96.15％（75/78）比93.79％（136/145）]、2年无瘤生存率[80.77％（63/78）比82.07％（119/145）]比较,差异均无统计学意义（均P〉0.05）.结论 胸腔镜单操作孔肺叶切除术治疗周围型肺癌可以达到与多操作孔相同的临床效果,是一种安全、有效、值得推广的手术方式.Objective To compare the clinical efficacy of single utility port and multiple utility ports thoracoscopic lobectomy in the treatment of peripheral lung cancer, and to study the operation skills, relative merit and feasibility of the single utility port thoracoscopic lobectomy. Methods The clinical data was analyzed retrospectively for 223 cases with stage Ⅰ orⅡ of peripheral lung cancer who underwent thoracoscopic lobectomy from July 2011 to November 2014 in Shanxi Provincial Cancer Hospital. Among 223 cases, 78 cases received single utility port thoracoscopic lobectomy （single utility port group）, 145 cases received 2 or 3 utility ports thoracoscopic lobectomy （multiple utility ports group）. The clinical outcomes involved time of operation, intraoperative blood loss,chest drainage, postoperative hospital stay, stations of lymph node dissection, numbers of lymph node dissection, rate of turn to open, postoperative complications, 2-year survival rate and disease free survival rate. Results No perioperative death occurred in both groups. There was no statistical difference between single utility port group and multiple utility ports group in operation time [（157.4 ±13.6） min vs. （151.3 ±23.2） min], intraoperative blood loss [（180.77 ±59.97） ml vs.（171.31 ±77.51） ml],chest drainage [（370.26 ±146.09） ml vs. （351.17 ±159.07） ml], lymph node dissection stations （4.29±0.65 vs. 4.21±0.73）, lymph node dissection number （11.50±2.30 vs. 11.04±2.29）, rate of turn to open [（5.13 % （4/78） vs. 4.83 % （7/145）], incidence of postoperative complications [17.95 % （14/78） vs. 15.86%（23/145）], postoperative hospital stay [（8.74±0.51） d vs. （9.48±0.63） d], 2-year survival rate [96.15 %（75/78） vs. 93.79%（136/145）] and 2-year disease free survival rate [80.77 % （63/78） vs. 82.07 % （119/145）] （all P〉0.05）. Conclusions The single utility port thoracoscopic lobectomy could achieve the same clinical results as the multiple utility ports.

关 键 词：肺肿瘤 胸外科手术 胸腔镜 单操作孔 

分 类 号：R734.2[医药卫生—肿瘤]