单孔胸腔镜下Ⅰ期非小细胞肺癌根治术中模块化系统性淋巴结清扫的应用研究  

Application of modular systematic lymph node dissection in uniportal thoracoscopic radical resection for stage I non-small cell lung cance

作　　者：贡会源[1,2] 杏福宝 李晨 李小军 耿阳[1] 陈鹏飞[1] GONG Huiyuan;XING Fubao;LI Chen;LI Xiaojun;GENG Yang;CHEN Pengfei(Department of Thoracic Surgery,the First Afiliated Hospital of Bengbu Medical College,Bengbu,Anhui 233004,China;不详)

机构地区：[1]蚌埠医学院第一附属医院胸外科,安徽蚌埠233004 [2]安徽省呼吸系统疾病(肿瘤)临床研究中心,安徽蚌埠233004

出　　处：《中华全科医学》2023年第9期1482-1486,共5页Chinese Journal of General Practice

基　　金：安徽省中央引导地方科技发展基金项目(2020b07030008);安徽省高等学校自然科学研究项目(KJ2020A0575)。

摘　　要：目的 探索在单孔胸腔镜非小细胞肺癌根治术中如何对系统性淋巴结清扫流程进行优化,并评估其临床应用效果及安全性。方法 选取2020年10月—2022年10月期间在蚌埠医学院第一附属医院胸外科行单孔胸腔镜非小细胞肺癌根治术的100例患者为研究对象,将其按不同的淋巴结清扫方式分为研究组和对照组,每组各50例。研究组术中采用模块化流程进行系统性淋巴结清扫,对照组术中采用常规流程行系统性淋巴结清扫。评估指标包括纵隔淋巴结清扫数目、手术时间、术中出血量、术后引流量、胸引管留置时间及术后住院时间等,对比2种淋巴结清扫流程在单孔胸腔镜肺癌根治术中的应用效果。结果 研究组纵隔淋巴结清扫数目[(7.6±0.9)个]明显优于对照组患者[(7.2±1.0)个],差异有统计学意义(P<0.05)。研究组的手术时间[(103.8±9.9)min]明显短于对照组[(121.4±9..3)min],术中出血量[(77.5±9.2)mL]、术后引流量[(268.1±16.4)mL]、胸引管留置时间[(3.4±0.9)d]及术后住院时间[(4.0±1.0)d]均少于对照组[(84.9±11.8) mL、(304.9±18.3)mL、(4.8±1.1)d、(5.4±1.1)d],差异有统计学意义(均P<0.05)。结论 在单孔胸腔镜非小细胞肺癌根治术中采用模块化流程行系统性淋巴结清扫,可以缩短手术时间,减少术后引流量及胸引管留置时间,有助于患者快速康复,安全性良好,值得临床推广应用。Objective To optimize the process of systematic lymph node dissection in single-port video-assisted thoracoscopic radical resection of non-small cell lung cancer and evaluate the clinical application effect and safety.Methods From October 2020 to October 2022,100 patients who underwent single-port thoracoscopic radical resection of non-small cell lung cancer at the Thoracic Surgery Department of the First Affiliated Hospital of Bengbu Medical College,were selected as the research subjects.They were then divided into study group and control group according to different ways of lymph node dissection,with 50 cases in each group.The study group used a modular approach to systematic lymph node dissection.In the control group,systematic lymph node dissection was performed routinely during the operation.Evaluation indicators included the number of dissected mediastinal lymph nodes,operation time,intraoperative blood loss,postoperative drainage volume,chest tube indwelling time and postoperative hospital stay.The application of two lymph node dissection techniques in single-port thoracoscopic radical resection of lung cancer was compared.Results The number of dissected mediastinal lymph nodes in the study group(7.6±0.9)was significantly better than that in the control group(7.2±1.0),and the difference was statistically significant(P<0.05).The operation time of the study group[(103.8±9.9)min]was significantly shorter than that of the control group[(121.4±9.3)min],and the intraoperative blood loss[(77.5±9.2)mL],postoperative drainage volume[(268.1±16.4)mL],chest tube indwelling time[(3.4±0.9)d]and postoperative hospital stay[(4.0±1.0)d]were all less than those of the control group[(84.9±11.8)mL,(304.9±18.3)mL,(4.8±1.1)d,(5.4±1.1)d],and the differences were statistically significant(all P<0.05).Conclusion In single-port thoracoscopic radical resection of non-small cell lung cancer,systematic lymph node dissection using modular procedures can shorten the operation time,reduce postoperative drainage volume and che

关 键 词：淋巴结清扫 单孔胸腔镜 Ⅰ期非小细胞肺癌 

分 类 号：R734.2[医药卫生—肿瘤] R730.56[医药卫生—临床医学]