摘要
目的探讨单孔与三孔单向式胸腔镜(single-direction video-assisted thoracic surgery,S-VATS)解剖性肺叶切除术治疗肺癌的可行性与近期疗效。方法回顾性分析2016年7月至2019年1月我院同一术者连续开展的60例S-VATS肺叶切除并纵隔淋巴结清扫术肺癌患者的临床资料,其中男40例、女20例,平均年龄(62.2±9.0)岁。依据术式不同将患者分为单孔S-VATS组与三孔S-VATS组,每组30例。比较两组患者的临床资料。结果全组无中转开胸、增加手术切口或死亡病例,气管切缘均阴性。单孔S-VATS组与三孔S-VATS组相比,手术时间差异无统计学意义[(70.8±16.4)min vs.(73.7±14.3)min,P>0.05]。两组术中出血量、清扫淋巴结站数及枚数、术后并发症发生率、胸腔引流管留置时间及术后住院时间等差异无统计学意义(P>0.05)。单孔S-VATS组患者术后3~14 d疼痛评分显著低于三孔S-VATS组(P<0.05)。平均随访10个月,患者均存活,无肿瘤复发或转移。结论由三孔S-VATS过渡到单孔S-VATS解剖性肺叶切除术治疗肺癌是可行的。此外,最优化的血管切除顺序需进一步研究明确。
Objective To explore the feasibility and short-term efficacy of uniportal and three-port single-direction video-assisted thoracoscopic surgery(S-VATS)anatomical lobectomy for lung cancer.Methods Clinical data of 60 lung cancer patients,including 40 males and 20 females with an average age of 62.2±9.0 years,who received S-VATS anatomic lobectomy and systematic lymph nodes dissection by the same surgeon in our hospital between July 2016 and January 2019 were retrospectively analyzed.These patients were divided into a uniportal S-VATS group and a three-port S-VATS group according to surgical procedures,with 30 patients in each group.The clinical data of the two groups were compared.Results There was no conversion to thoracotomy,surgical port addition,or mortality in this cohort,with tumor-negative surgical margin.There was no statistical difference in the operation time between the two groups(70.8±16.4 min vs.73.7±14.3 min,P>0.05).Meanwhile,both groups showed similar intraoperative blood loss,stations and numbers of dissected lymph nodes,incidence of operation-related complications,duration and volume of chest tube drainage,as well as postoperative hospital stay(P>0.05).Besides,pain score of the patients in the uniportal S-VATS group was significantly lower than that of the three-port S-VATS group on postoperative 3-14 d(P<0.05).The mean duration of follow-up was 10 months,and all the patients were survived without tumor recurrence or metastasis.Conclusion The transition from three-port S-VATS to uniportal S-VATS anatomical lobectomy for treatment of lung cancer is feasible.However,further studies are needed to elucidate the optimal resection sequence of pulmonary vessels.
作者
王帅
张淼
张辉
刘冬
武文斌
WANG Shuai;ZHANG Miao;ZHANG Hui;LIU Dong;WU Wenbin(Department of Thoracic Surgery,Xuzhou Central Hospital,Xuzhou,221009,Jiangsu,P.R.China)
出处
《中国胸心血管外科临床杂志》
CAS
CSCD
2020年第6期663-668,共6页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
关键词
单向式
单孔
胸腔镜手术
肺叶切除术
外科手术
Single-direction
uniport
video-assisted thoracoscopic surgery(VATS)
lobectomy
surgery
