【摘要】 目的 对比分析单孔、单操作孔及三孔胸腔镜下肺叶切除术治疗早期非小细胞肺癌(NSCLC)的临床疗效。方法 选择2017年3月—2020年3月蚌埠市第三人民医院胸外科行胸腔镜下肺叶切除手术治疗的104例早期NSCLC患者的临床资料,根据胸腔镜不同术式分为单孔组(32例)、单操作孔组(36例)和三孔组(36例),对比分析3组患者术中及术后相关资料。结果 3组患者手术均顺利完成,术中及术后无严重并发症,均治愈后出院。单孔组手术时间明显长于单操作孔组及三孔组(P<0.05),三孔组手术时间最短(P<0.05)。术后48 h疼痛评分单孔组患者明显低于单操作孔及三孔组(P<0.05),三孔组最高(P<0.05)。3组患者术中出血量、淋巴结清扫个数、胸引管留置时间及术后住院时间的差异均无统计学意义(P>0.05)。结论 单孔、单操作孔及三孔胸腔镜下肺叶切除术均是治疗早期NSCLC的有效手术方式。三孔法手术时间短,适合初期开展手术者,单孔胸腔镜技术切口更美观,术后疼痛最小,但操作难度较大,可在胸腔镜技术熟练后逐步开展。更多还原

【Abstract】 Objective To compare and analyze the clinical efficacy of uniportal video-assisted thoracic surgery(VATS),single utility port VATS and 3-portal VATS lobectomy for patients with early stage non-small cell lung cancer(NSCLC).Methods From March 2017 to March 2020,104 patients with early stage NSCLC underwent thoracoscopic lobectomy in the Department of Thoracic Surgery of the Third People’s Hospital of Bengbu City were selected.Among them,32 cases were in the uniportal VATS lobectomy group,36 cases were in the single utility port VATS lobectomy group,36 cases were in the 3-portal VATS lobectomy group,according to the different methods of thoracoscopic surgery.Data of intraoperative and postoperative patients in three groups were compared and analyzed.Results All three groups were successfully operated and recovered and discharged from hospital without serious complications during perioperative period.The operation time of uniportal VATS lobectomy group was significantly longer than that of single utility port VATS lobectomy group(P<0.05) and 3-portal VATS lobectomy group(P<0.05),operation time in 3-portal VATS lobectomy group was the shortest(P<0.05).Postoperative pain score in the uniportal VATS lobectomy group was significantly lower than that in the single utility port VATS lobectomy group(P<0.05)and 3-portal VATS lobectomy group(P<0.05),highest in the 3-portal VATS lobectomy group(P<0.05).There was no statistically significant difference in the amount of intraoperative bleeding volume,number of lymph node dissection,drainage time and length of stay among the three groups of patients(P>0.05).Conclusion Uniportal video-assisted,single utility port video-assisted and 3-portal video-assisted thoracic surgery are effective surgical methods for patient of early stage NSCLC.At the beginning of thoracoscope lobectomy,the author recommends the three-hole method.On the basis of having a certain3-portal VATS lobectomy,the single utility port VATS lobectomy can be used as the first.The uniportal VATS lobectomy is more aesthetically pleasing and has the least postoperative pain,while the operation is more diffiicult and the initial operation time is longer.更多还原