单向式三孔胸腔镜肺叶切除术治疗早期肺癌应用研究  

Analysis of a study about single-direction three-port thoracoscopic surgery lobectomy for early-stage lung cancer

作　　者：宁晓矿 郝普明 闫睿 刘云泽 李宬润 Xiaokuang Ning;Puming Hao;Rui Yan;Yunze Liu;Chengrun Li(Department of Thoracic Surgery,the First Hospital of Yongnian District,Hebei 056000,China;Department of Thoracic Surgery,the Third Medical Center,Chinese PLA General Hospital,Beijing 100039,China;Department of Thoracic Surgery,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Chinese PLA Medical School,Beijing 100853,China)

机构地区：[1]邯郸市永年区第一医院胸外科,河北056000 [2]解放军总医院第三医学中心胸外科,北京100039 [3]解放军总医院第一医学中心胸外科,北京100853 [4]解放军医学院,北京100853

出　　处：《中华腔镜外科杂志（电子版）》2023年第4期227-232,共6页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

基　　金：首都临床特色诊疗技术研究及转化应用(Z221100007422124)。

摘　　要：目的:探讨单向式三孔胸腔镜(single-direction three-port video-assisted thoracoscopic surgery,ST-VATS)肺叶切除术在治疗早期肺癌中的优势。方法:连续性回顾性分析2020年7月至2022年5月于解放军总医院第一医学中心确诊肺恶性肿瘤并行三孔VATS肺叶切除、系统性淋巴结清扫手术的病例资料。选取200例,根据手术方式的不同分为ST-VATS组(100例)和常规三孔胸腔镜(conventional T-VATS,CT-VATS)组(100例);比较两组肺叶切除的手术时间、术中出血量、淋巴结清扫个数、术后3 d引流量、引流管留置时间和术后并发症等指标。结果:两组无围术期死亡且病理切缘阴性。两组术中出血量、淋巴结清扫个数、术后3 d引流量差异无统计学意义;与CT-VATS组比较,ST-VATS组患者手术时间短[(56.29±13.35)min vs.(63.78±14.91)min,P=0.001],引流管留置时间短[3(3)d vs.5(4)d,P<0.0001],差异具有统计学意义(P<0.05)。结论:ST-VATS肺叶切除术与CT-VATS肺叶切除手术相比较具有缩短手术时间和引流管留置时间的优点,并且手术效果相当,是一种安全有效且值得推广的手术方式。Objective To explore the advantages of single-direction three-port thoracoscopic surgery(ST-VATS)lobectomy in the treatment of early-stage lung cancer.Methods Clinical data of consecutive VATS lobectomy and systematic lymph nodes dissection with lung malignant tumor confirmed in the First Medical Center,Chinese PLA General Hospital between Jul.2020 and May 2022.The data of 200 patients were selected for analysis and were divided into a ST-VATS group with 100 patients and a conventional T-VATS(CT-VATS)group;The operation time,intraoperative blood loss,number of dissected lymph nodes,3d postoperative drainage volume,postoperative chest drainage time and postoperative complications were compared respectively between the groups.Results There was no perioperative mortality and tumor-negative surgical margin in groups.The two groups were no statistically difference in intraoperative blood loss,number of dissected lymph nodes and 3 d postoperative drainage volume.As compared with the CT-VATS group,patients in the ST-VATS group demonstrated shorter operation time[(56.29±13.35)min vs.(63.78±14.91)min,P=0.001]and shorter postoperative chest drainage time[3(3)d vs.5(4)d,P<0.0001],with statistical differences(P<0.05).Conclusion Compared with CT-VATS lobectomy,the ST-VATS lobectomy has the advantages of shorter operation time and postoperative chest drainage time.Additionally,it achieves the same surgical outcomes,making it a safe,effective,and promotable surgical approach.

关 键 词：胸腔镜 单向式肺叶切除 早期肺癌 

分 类 号：R73[医药卫生—肿瘤]