目的 比较分析单孔全胸腔镜解剖性肺段切除术与肺叶切除术治疗非小细胞肺癌的疗效.方法 回顾性分析2018年6月到2023年6月信阳市中心医院收治的行单孔全胸腔镜解剖性肺段切除术治疗的60例非小细胞肺癌患者(A组)和行单孔全胸腔镜解剖性肺叶切除术治疗的60例非小细胞肺癌患者(B组),比较2组围手术期指标、肺功能指标、炎症指标、并发症发生情况等.结果 A组手术时间长于B组,术中出血量、术后12 h引流量、住院时间均低于 B 组(t=2.272,P=0.025;t=9.660,P＜0.001;t=12.703,P＜0.001;t=11.706,P＜0.001).A组和B组术后3个月第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、每分钟最大通气量(MVV)均低于术前1 d(P＜0.05),且 A 组术后 3 个月 FVC、FEV1、MVV 高于 B 组(t=5.166,P＜0.001;t=4.108,P＜0.001;t=5.861,P＜0.001).A组术后1 d、术后3 d肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1 β)、IL-6、C反应蛋白(CRP)均低于B组,A组和B组术后3 d TNF-α、IL-1β、IL-6、CRP均低于术后1 d(P均＜0.05).A组并发症总发生率低于B组(x2=0.901,P=0.343).结论 单孔全胸腔镜解剖性肺段切除术与肺叶切除术治疗非小细胞肺癌均有较好的预后,并发症发生风险小,且单孔全胸腔镜解剖性肺段切除术对患者肺功能影响更小,炎症反应更轻,术后恢复更快.
Comparison of efficacy of single hole thoracoscopic anatomical segmental resection and lobectomy in the treatment of non-small cell lung cancer
Objective To compare the efficacy of single hole total thoracoscopic anatomical segmental resection and lobectomy in the treatment of non-small cell lung cancer.Methods A retrospective collection of 60 patients with non-small cell lung cancer treated by single hole total thoracoscopic anatomic segmental resection treated in Xinyang Central Hospital from June 2018 to June 2023 was included in group A,and 60 patients with non-small cell lung cancer treated by single hole total thoracoscopic anatomic lobectomy were included in group B.The perioperative indexes,pulmonary function inde-xes,inflammatory indexes and complication occurrence were compared between the two groups.Results The operation time of group A was higher than that of group B,The intraoperative blood loss,12 h postoperative drainage,length of hospi-tal stay were lower than those in group B(t=2.272,P=0.025;t=9.660,P＜0.00];t=12.703,P＜0.001;t=11.706,P＜0.001).The forced expiratory volume(FEV1),forced vital capacity(FVC)and maximum volume per minute(MVV)in the first second of 3 months after surgery were all decreased compared with those in the first day before surgery(P＜0.05).The FVC,FEV1,MVV in group A 3 months after operation were higher than those in group B(t=5.166,P＜0.001;t=4.108,P＜0.001;t=5.861,P＜0.001).The tumor necrosis factor-α(TNF-α),interleukin-1 β(IL-1 β),IL-6 andC-reactive protein(CRP)in 1 day and 3 days after surgery in group A were lower than those in group B,the TNF-α,IL-1 β,IL-6 and CRP in 3 days after surgery in group A and group B were lower than those in 1 day after surgery(P＜0.05).The complication occurrence in group A was lower than that in group B(x2=0.901,P=0.343).Conclusion In the treatment of non-small cell lung cancer,both single hole thoracoscopic anatomic segmental resection and lobectomy have better prognosis and less risk of complications.Moreover,single-port thoracoscopic anatomic segmental resection has less impact on lung function,less inflammatory reaction and faster postoperative recovery.
non-small cell lung cancersingle hole thoracoscopesegmental resection of lungpulmonary lobectomy
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