基于三维重建技术的胸腔镜手术治疗非小细胞肺癌的临床分析  

Clinical Analysis of Thoracoscopic Surgery for Non-small Cell Lung Cancer Based on Three-Dimensional Reconstruction Technology

作　　者：刘双双 朱正帅 杨子林 段东奎[1] 田永京[1] LIU Shuangshuang;ZHU Zhengshuai;YANG Zilin;DUAN Dongkui;TIAN Yongjing(Department of Cardiothoracic Surgery,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院心胸外科,河南南阳473000

出　　处：《河南医学研究》2023年第11期2000-2004,共5页Henan Medical Research

基　　金：2020年度河南省医学科技攻关计划项目(LHGJ20200907)。

摘　　要：目的探讨三维重建技术在胸腔镜手术治疗非小细胞肺癌(NSCLC)患者中的临床效果,以期制定个性化手术方案,提高手术的安全性和有效性。方法采用前瞻性随机对照研究,纳入2019年7月至2021年7月南阳市中心医院收治的NSCLC患者为研究对象,均行全胸腔镜肺段切除术治疗,根据术前是否进行三维重建分为重建组和未重建组。记录患者手术切除部位、围手术期情况、住院期间并发症情况;术后随访12个月,记录患者远期预后情况。结果共纳入128例患者,重建组64例,未重建组64例。其中重建组2例术后病理证实为淋巴结转移,1例术中转为开胸手术,均给予剔除;未重建组2例术中转为开胸手术,给予剔除。最终重建组61例,未重建组62例纳入本次研究。三维重建组进行复杂肺段21例,简单肺段40例;未重建组进行复杂肺段17例,简单肺段45例。两组手术难度差异无统计学意义(χ^(2)=0.707,P=0.400);重建组手术时间、术后拔管时间、住院时间短于未重建组,术中出血量、术后引流量少于未重建组(P<0.05);重建组术中清扫淋巴结组数及清扫淋巴结个数均少于未重建组(P<0.05);住院期间,重建组术后并发症发生率低于未重建组(P<0.05);两组术后随访12个月,均未出现术后复发、转移或病死。结论三维重建技术下行胸腔镜手术治疗NSCLC患者在手术时间、术中出血量、拔管时间、术后引流量、住院时间等较非重建更具优势,同时该技术可提高手术的精确度、安全性,降低术后并发症发生率。Objective To explore the clinical effect of three-dimensional reconstruction technology in the treatment of non-small cell lung cancer(NSCLC)patients with thoracoscopic surgery,so as to formulate a personalized surgical plan and improve the safety and effectiveness of surgery.Methods A prospective randomized controlled study was conducted.The patients with NSCLC admitted to Nanyang Central Hospital from July 2019 to July 2021 were included in this study.All patients underwent total thoracoscopic segmentectomy.They were divided into reconstruction group and non reconstruction group according to whether three-dimensional reconstruction was performed before surgery.The surgical resection site,perioperative conditions and complications during hospitalization were recorded.The patients were followed up for 12 months to record their long-term prognosis.Results A total of 128 patients were enrolled,64 in the reconstruction group and 64 in the non reconstruction group.In the reconstruction group,2 cases were pathologically confirmed as lymph node metastasis,and 1 case was converted to thoracotomy,all of which were removed.In the non reconstruction group,2 cases were converted to thoracotomy and were removed.A total of 61 cases in the final reconstruction group and 62 cases in the non reconstruction group were included in this study.In the three-dimensional reconstruction group,21 patients with complex lung segments and 40 patients with simple lung segments were performed.In the non reconstruction group,17 patients underwent complex lung segments and 45 patients underwent simple lung segments.There was no statistical significant difference in surgical difficulty between the two groups(χ^(2)=0.707,P=0.400).The operation time,extubation time and hospitalization time in the reconstruction group were shorter than those in the non reconstruction group,and the intraoperative blood loss and postoperative drainage volume were less than those in the non reconstruction group(P<0.05).The number of dissected lymph nodes and the numb

关 键 词：非小细胞肺癌 三维重建技术 全胸腔镜肺段切除术 

分 类 号：R734.2[医药卫生—肿瘤]