单孔胸腔镜与单操作孔胸腔镜肺叶切除术围手术期及近期临床疗效比较

目的 探讨单孔胸腔镜及单操作孔胸腔镜在肺叶切除术中的安全性及临床意义,比较2种手术入路治疗肺部疾病的临床疗效。 方法 选取2017年1月-2018年1月在蚌埠医学院第一附属医院胸外科行胸腔镜肺叶切除手术的患者76例,其中单孔27例,单操作孔49例,收集并比较2种不同手术入路围手术期各临床数据,包括手术时间(min)、术中出血量(ml)、淋巴结清扫数目(枚)、前3 d总引流量(ml)、胸引管留置时间(d)、术后住院时间(d)、术后第3天视觉模拟疼痛评分(visual analogue scale,VAS)、术后并发症发生率。 结果 单孔组及单操作孔组均无手术死亡病例。二者手术时间、术中出血量、淋巴结清扫数目、胸引管留置时间、并发症发生率比较差异均无统计学意义(均P>0.05)。单孔组与单操作孔组的前3 d引流总量、术后住院时间、术后第3天VAS疼痛评分比较差异具有统计学意义(均P<0.05)。2组病例术后随访半年均无复发。 结论 单孔胸腔镜肺叶切除治疗部分肺部良恶性疾病安全、有效,某些方面甚至优于单操作孔胸腔镜,值得推广。 

Perioperative and short-term clinical efficacy comparison of pulmonary lobectomy with single-port VATS and single-operation-port VATS

Objective To explore the safety and clinical significance of single-port video-assisted thoracic surgery (VATS) and single-operation-port VATS in lobectomy for pulmonary diseases. Methods We selected 76 cases of patients who underwent thoracoscopic lobectomy from January, 2017 to January, 2018 in thoracic surgery department of the first Affiliated Hospital of Bengbu Medical College. Among all the cases, 27 patients underwent single-port VATS (SP group); 49 patients underwent single-operation-port VATS (SOP group). The clinical data including operation time, intraoperative bleeding loss, the number of lymph node, the volume of drainage in the first three days, the chest tube time, postoperative hospital stay, incision pain VAS scores on postoperative day 3 and incidence of complications of the two different surgical approaches were collected and compared. Results No operative morality occurred in both groups.There were no statistical significances between the two groups in the operation time, the intraoperative bleeding loss, the number of lymph node, the chest tube time, the incidence of complications. While the SP group had significant less volume of drainage in the first three days, shorter postoperative hospital stay, incision pain VAS scores on postoperative day 3 as compared with the SOP group. No recurrence was found in both groups during a follow-up time of 6 months. Conclusion Single-port video-assisted thoracic surgery in lobectomy for benign and malignant pulmonary diseases is safe, effective and worthy of promotion.