单孔胸腔镜肺叶切除术治疗老年患者非小细胞肺癌的效果观察  

Effect of single-port thoracoscopic lobectomy on non-small cell lung cancer in elderly patients

作　　者：李晓亮[1] 姚益 刘蔡杨 杨彦辉[1] 李季[1] LI Xiao-liang;YAO Yi;LIU Cai-yang;YANG Yan-hui;LI Ji(Department of Cardiothoracic Surgery,First People’s Hospital of Neijiang,Neijiang Sichuan 641000,China)

机构地区：[1]内江市第一人民医院胸心外科,四川内江641000

出　　处：《局解手术学杂志》2021年第8期723-726,共4页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的对比分析单孔、三孔胸腔镜肺叶切除术治疗70岁及以上非小细胞肺癌(NSCLC)患者的临床疗效。方法收集92例接受胸腔镜肺叶切除术的70岁及以上NSCLC患者的临床资料,根据手术方式将其分为单孔组(52例)和三孔组(40例)。对比分析2组患者手术时间、术中出血量、术后3 d总引流量、淋巴结清扫数目、术后胸引管留置时间、术后ICU监护时间、住院时间、术后疼痛程度及术后并发症发生情况。随访分析2组患者早期病死率、总存活率及无事件生存率差异。结果单孔组术中出血量、术后3 d总引流量、术后胸引管留置时间、住院时间少/短于三孔组,差异有统计学意义(P<0.05);而2组手术时间、术后ICU监护时间、淋巴结清扫数目比较,差异无统计学意义(P>0.05)。2组患者术后12 h、24 h、48 h的VAS评分逐渐降低(P<0.05);且单孔组术后12 h、24 h、48 h的VAS评分均低于三孔组,差异有统计学意义(P<0.05)。2组术后并发症、早期病死率、随访期间总存活率、无事件生存率比较,差异均无统计学意义(P>0.05)。结论单孔胸腔镜肺叶切除术治疗70岁及以上NSCLC患者具有创伤小、恢复快、安全等优势,患者远期生存可达到与三孔胸腔镜肺叶切除术一样的效果。Objective To compare and analyze the clinical efficacy of single-port and three-port thoracoscopic lobectomy in the treatment of patients aged 70 years and older with non-small cell lung cancer(NSCLC).Methods The clinical data of 92 patients aged 70 years and older with NSCLC who underwent thoracoscopic lobectomy were collected,the patients were divided into the single-port group(52 cases)and the three-port group(40 cases).The operation time,intraoperative blood loss,total drainage volume of 3 days after operation,the number of lymph node dissection,postoperative catheterization time,postoperative ICU monitoring time,hospital stay,the degree of postoperative pain and postoperative complications were compared and analyzed between the two groups.The patients of the two groups were followed up,and the differences in the early fatality rate,overall survival rate and event-free survival rate of patients in the two groups were analyzed.Results The intraoperative blood loss,postoperative drainage volume of 3 days after operation,postoperative catheterization time and hospital stay of the single-port group were less/shorter than those of the three-port group,the differences were statistically significant(P<0.05).However,there was no significant difference in the operation time,postoperative ICU monitoring time,and the number of lymph node dissection between the two groups(P>0.05).The VAS scores of the two groups gradually decreased 12 hours,24 hours and 48 hours after surgery(P<0.05).The VAS scores of the single-port group 12 hours,24 hours and 48 hours after surgery were lower than those of the three-port group,and the differences were statistically significant(P<0.05).There was no significant difference in the postoperative complications,the early fatality rate,overall survival rate or event-free survival rate during the follow-up between the two groups(P>0.05).Conclusion Single-port thoracoscopic lobectomy for the treatment of NSCLC patients aged 70 and older has the advantages of less trauma,faster recovery,and more

关 键 词：单孔胸腔镜 三孔胸腔镜 老年 非小细胞肺癌 

分 类 号：R734.2[医药卫生—肿瘤]