单孔与三孔胸腔镜肺叶切除术的临床疗效对比

摘要:目的 对比单孔胸腔镜肺叶切除术 （Uniportal VATS） 与三孔胸腔镜肺叶切除术 （3-portal VATS） 治疗肺癌的临床疗效。方法 肺癌患者行单孔胸腔镜肺叶切除术 45 例为单孔组， 肺癌患者行三孔胸腔镜肺叶切除术 53 例为三孔组， 比较 2 组患者的手术时间、 术中出血量、 淋巴结清扫数、 切口长度、 术后拔管时间、 术后疼痛评分、 术后住院天数、 并发症发生率及患者满意度评分等。结果 单孔组与三孔组术中出血量[ （128.75±18.32） mL vs（129.15± 17.69） mL]、 淋巴结清扫数[ （13.33±1.05） 枚 vs （13.12±1.38） 枚]、 术后拔管时间[ （4.90±0.75） d vs （4.75±0.70） d]、 术后住院天数[ （7.52±1.16） d vs （7.55±1.10） d]、 并发症发生率 （20.0% vs 20.8%） 等比较差异均无统计学意义。单孔组在切口长度[ （5.36±0.22） cm vs（7.44±0.35） cm]、 术后第 1 天疼痛评分[6.47±0.54 vs 6.86±0.52] 、 第 3 天疼痛评分[3.59±0.29 vs 4.05±0.25]、 患者满意度评分[91.03±2.62 vs 88.35±2.97]等方面均优于三孔组 （均 P < 0.05）， 单孔组的手术时间较三孔组[ （143.81±17.97） min vs （130.11±15.03） min]略有延长 （P < 0.05）。结论 单孔胸腔镜肺叶切除术治疗肺癌安全、 有效， 较传统三孔胸腔镜肺叶切除术创伤更小， 疼痛更轻， 患者满意度更高。

Comparison of clinical effects between uniportal video-assisted thoracic surgery and 3-portal video-assisted thoracic surgery in pulmonary lobectomy

Abstract:Objective To compare the clinical effects between uniportal video-assisted thoracic surgery (VATS) and 3- portal VATS lobectomy for patients with lung cancer. Methods Patients were divided into uniportal VATS lobectomy group (n=45) and 3-portal VATS lobectomy group (n=53). The clinical data were compared between two groups, including the oper⁃ ation time, intraoperative blood loss, number of lymph node dissection, length of incision, postoperative extubation time, post⁃ operative pain score and postoperative hospitalization. Results There were no significant differences in intraoperative blood lose (128.75±18.32) mL vs (129.15±17.69) mL, lymph node dissection number (13.33±1.05) vs (13.12±1.38), duration of chest drainage (4.90±0.75)d vs (4.75±0.70)d, duration of hospital stay (7.52±1.16)d vs (7.55±1.10)d and incidence of seri⁃ ous postoperative complications between two groups (P>0.05). The incision length (5.36±0.22)cm vs (7.44±0.35)cm, numeric pain intensity scale including first day(6.47±0.54) vs (6.86±0.52)， third day(3.59±0.29) vs (4.05±0.25), and patient satisfac⁃ tion scores (91.03±2.62) vs (88.35±2.97) were significantly better in uniportal VATS group than those of 3-portal VATSgroup (P<0.05). The operation time (143.81±17.97) min vs （130.11±15.03） min was longer in uniportal VATS group than that of 3-portal VATS group (P < 0.05). Conclusion Uniportal VATS lobectomy is safe and reliable for patients with early- stage lung cancer, which has less surgical injury, slighter pain, and higher satisfaction than 3-portal VATS lobectomy.