单孔与多孔亚肺叶切除术治疗早期非小细胞肺癌的疗效探讨OACSTPCD
Curative effect discussion of single-port and multi-port video-assisted thoracic surgery sublobectomy on early non-small cell lung caicinoma
目的:探讨单孔与多孔胸腔镜亚肺叶切除术治疗早期非小细胞肺癌的临床疗效.方法:选取 2020 年 1 月至2022 年12 月收治的150 例早期非小细胞肺癌患者,按随机数字法分为单孔组、两孔组与三孔组,每组50 例.比较三组手术情况、术后恢复情况、住院时间、并发症情况、术后第1 天与第3 天疼痛视觉模拟评分及术前、术后第3 天血清肿瘤坏死因子-α、白介素-6、超敏C反应蛋白水平;分别于术前1d、术后3 个月检测第1 秒用力呼气容积、用力肺活量、最大通气量.结果:单孔组术中出血量、术后胸腔引流量少于两孔组、三孔组,术后第1 天、第3 天疼痛评分低于另两组,术后引流时间、住院时间短于另两组,术后第3 天肿瘤坏死因子-α、白介素-6、超敏C反应蛋白水平均低于另两组(P<0.05);3 组间术后 1 个月第 1 秒用力呼气容积、用力肺活量、最大通气量差异无统计学意义(P>0.05);单孔组术后并发症发生率为6.00%,低于两孔组(20.00%)与三孔组(24.00%),差异有统计学意义(P<0.05).结论:单孔胸腔镜亚肺叶切除术治疗早期非小细胞肺癌的手术效果与多孔胸腔镜手术相近,可缩短术后引流时间、住院时间,降低术后疼痛与炎症反应程度.
Objective:To explore the curative effect of single-port and multi-port video-assisted thoracic surgery sublobectomy on early non-small cell lung cancer.Methods:A total of 150 patients with early non-small cell lung cancer admitted between Jan.2020 and Dec.2022 were enrolled.According to the random number table method,they were divided into single-port group(single-port video-assisted thoracic surgery sublobectomy),two-port group(two-port video-assisted thoracic surgery sublobectomy)and three-port group(three-port video-assisted thoracic surgery sublobectomy),with 50 cases in each group.The surgical situations,postoperative recovery,hospital stay,incidence of postoperative complications,scores of visual analogue scale at 1 d and 3 d after surgery,levels of serum tumor necrosis factor-α,interleukin-6 and hypersensitive C-reactive protein before surgery and 3 d after surgery,forced expiratory volume in one second,forced vital capacity and maximal voluntary ventilation at 1 d before surgery and 3 months after surgery were compared among the three groups.Results:Compared with two-port group and three-port group,in single-port group intraoperative blood loss and postoperative thoracic drainage volume were less,pain scores of visual analogue scale were lower at 1 d and 3 d after surgery,postopera-tive drainage time and hospital stay were shorter(P<0.05).At 3 d after surgery,levels of tumor necrosis factor-α,interleukin-6 and hypersensitive C-reactive protein in the single-port group were lower than those in the two-port group and the three-port group(P<0.05).There were no significant differences in forced expiratory volume in one second,forced vital capacity and maximal voluntary ven-tilation among the three groups at 1 month after surgery(P>0.05).The incidence of postoperative complications in the single-port group was6.00%,which was significantly lower than that in the two-port group and the three-port group(20.00%,24.00%,P<0.05).Conclusions:The surgical effect of both single-port and multi-port video-assisted thoracic surgery sublobectomy is similar for patients with early non-small cell lung cancer.The single-port video-assisted thoracic surgery sublobectomy can shorten postoperative drainage time and hospitalization time,and relieve postoperative pain and inflammatory response.
王代平;王世平;何学东;马伟;钟庆
简阳市人民医院胸外科,四川 简阳,641400简阳市人民医院麻醉科
临床医学
早期非小细胞肺癌亚肺叶切除术胸腔镜检查单孔多孔
Early non-small cell lung carcinomaPulmonary sublobectomyThoracoscopySingle-portMulti-port
《腹腔镜外科杂志》 2024 (003)
179-183 / 5
四川省医学科研课题计划项目(S20037);简阳市人民医院课题项目(JY202307)
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