【作者】 朱峰；

【导师】 马海涛；

【作者基本信息】 苏州大学 ， 临床医学胸心外科， 2017， 硕士

【摘要】 目的:通过比较单孔全胸腔镜手术(uniportal video-assisted thoracic surgery)与传统三孔胸腔镜手术(3-portal video-assisted thoracic surgery)治疗早期非小细胞肺癌(NSCLC)的围术期临床疗效。方法:1.将2015年1月至2016年07月苏州大学第一附属医院心胸外科收治的81例早期NSCLC患者,根据选择两种不同手术方式,将资料分为单孔全胸腔镜手术组(36例)和三孔胸腔镜手术组(45例)。经统计分析,性别、年龄、病变部位、病理类型及TNM分期均无显著差异。2.统计两组患者在手术时间、术中出血量、术中淋巴结清扫数目、术后引流时间及总引流量、术后拔除胸腔引流管时间以及术后5日内疼痛评分等级,同时比较两组术后并发症发生情况。结果:1.两组患者均顺利完成手术,无中转开胸,无围手术期死亡病例。2.比较两组患者在手术时间、术中淋巴结清扫数目和术后并发症发生,差异无统计学意义(P>0.05)。3.比较单孔全胸腔镜手术组患者术中出血量、术后引流时间、总引流量、术后3日疼痛评分等级,结果单孔组均优于三孔胸腔镜手术组,差异有统计学意义(P<0.05)。结论:1.单孔全胸腔镜肺叶切除加淋巴结清扫术是一种安全、微创、可靠、合理的新2.型术式。3.单孔与三孔全胸腔镜肺叶切除术均属于微创心胸外科手术,都具有手术创伤小、术后恢复快等优点。且单孔胸腔镜手术在一定范围内更具有减轻患者术后疼痛,减少住院时间等优势,是一种可作为早期非小细胞肺癌治疗的推荐手术方式。更多还原

【Abstract】 ObjectiveTo compare the uniportal video-assisted thoracoscopic surgery(Uniportal video-assisted thoracic surgery)and the traditional 3-portal thoracoscopic surgery(3-portal video-assisted thoracic surgery)for treatment of early stage non-small cell lung cancer(NSCLC)perioperative clinical curative effect.Methods1.81 cases of early NSCLC patients from January 2015 to july 2016 of cardiothoracic surgery,the First Affiliated Hospital of Soochow University were divided into Uniportal video-assisted thoracoscopic surgery group(36 cases)and 3-portal thoracoscopic surgery group(45 cases)2.two groups of patients in the operation time,intraoperative blood loss,number of lymph node dissection,postoperative drainage time and total drainage volume,postoperative chest tube removal time and after 5 days of pain grade,comparing two groups of postoperative complications.ResultsTwo groups of patients were successfully completed the operation,no conversion to thoracotomy,no perioperative deaths.The operation time,two groups in the number of lymph node dissection and postoperative complications were compared,the difference was not statistically significant(P>0.05);but the amount of bleeding,patients with Uniportal video-assisted thoracoscopic surgery group after total drainage time,drainage volume,postoperative pain score 3 levels were less than3-portal thoracoscopic surgery group,the difference was statistically significant(P<0.05).ConclusionUniportal thoracoscopic lobectomy is safe,minimally invasive and reliable than the traditional 3-portal thoracoscopic lobectomy,small trauma,quick recovery,can be used as the recommended surgical treatment of early stage non-small cell lung cancer.更多还原