单孔、双孔及三孔胸腔镜治疗非小细胞肺癌患者近期结果对比观察

目的比较单孔、双孔及三孔胸腔镜治疗非小细胞肺癌患者的近期疗效。方法选取2015年3月～2016年2月在我院治疗的非小细胞肺癌患者99例作为研究对象,根据治疗方式不同将患者均分为三组,即A组(单孔)、B组(双孔)、C组(三孔),每组33例,比较三组患者的近期治疗有效率、疼痛评分和淋巴结清扫个数。结果三组患者的治疗有效率比较及三组患者的治疗有效率两两比较,差异均无统计学意义(P0.05)。A组患者的疼痛评分、淋巴结清扫个数与其他两组比较,差异均有统计学意义(P0.05);B组与C组患者疼痛评分、淋巴结清扫个数比较,差异均无统计学意义(P0.05)。结论单孔、双孔、三孔胸腔镜三种手术方式存在差异,且均具有各自的优势。单孔操作法应用范围相对较窄,淋巴结清扫效果相对较差,且对手术医师的技能要求较高;双孔操作法降低了操作口对患者机体造成的损伤;三孔操作法因打孔较多,可导致患者出血量增加,且术后疼痛感较为明显,但淋巴结清扫效果较好,临床应根据患者的病情选择适当的手术方式。

A comparison of recent achievements of thoracoscopic surgery in nonsmall cell lung cancer between a single-,two-and three-port thoracoscopy

Objective To compare the recent therapeutic efficacy of thoracoscopic surgery in non-small cell lung cancer (NSCLC) between a single-,two-and three-port thoracoscopy.Methods A total of 99 patients with NSCLC treated in our hospital from March 2015 to February 2016 were selected as subjects.They were divided into three groups according on different treatments,including group A (using a single-port thoracoscopy),group B (using a two-port thoracoscopy)and group C(using a three-port thoracoscopy),with 33 in each group.Their effective rates,pain scores and number of lymph node dissection were compared.Results There were no significant differences in effective rates among the three groups and between any pair (P>0.05).Compared with the other two groups,pain scores and the number of lymph node dissection in group A was statistically significant(P<0.05).However,there were no significant differences in the two indices between group B and group C (P>0.05).Conclusion The single-,two-and three-port thoracoscopy presented their own advantages in different approaches of thoracoscopy.The application of single-port thoracoscopy is relatively narrow with a limited lymph node dissection,which is skill-demanding to surgeons.The two-port thoracoscopy,featuring less operative tunnels,brings about less surgical trauma for patients.However,the three-port thoracoscopy may increase operative site bleeding and post-operative pain due to more operative tunnels,but with favorable effects in lymph node dissection.So an appropriate selection of thoracoscopy must depend on the condition of a patient in clinical practices.