摘要
目的:探讨单向式三孔胸腔镜(single-direction three-port video-assisted thoracoscopic surgery，ST-VATS)肺叶切除术在治疗早期肺癌中的优势。方法:连续性回顾性分析2020年7月至2022年5月于解放军总医院第一医学中心确诊肺恶性肿瘤并行三孔VATS肺叶切除、系统性淋巴结清扫手术的病例资料。选取200例，根据手术方式的不同分为ST-VATS组(100例)和常规三孔胸腔镜(conventional T-VATS，CT-VATS)组(100例)；比较两组肺叶切除的手术时间、术中出血量、淋巴结清扫个数、术后3 d引流量、引流管留置时间和术后并发症等指标。结果:两组无围术期死亡且病理切缘阴性。两组术中出血量、淋巴结清扫个数、术后3 d引流量差异无统计学意义；与CT-VATS组比较，ST-VATS组患者手术时间短[(56.29±13.35)min vs.(63.78±14.91)min，P＝0.001]，引流管留置时间短[3(3)d vs.5(4)d，P<0.0001]，差异具有统计学意义(P<0.05)。结论:ST-VATS肺叶切除术与CT-VATS肺叶切除手术相比较具有缩短手术时间和引流管留置时间的优点，并且手术效果相当，是一种安全有效且值得推广的手术方式。
Abstract
Objective:To explore the advantages of single-direction three-port thoracoscopic surgery(ST-VATS)lobectomy in the treatment of early-stage lung cancer.Methods:Clinical data of consecutive VATS lobectomy and systematic lymph nodes dissection with lung malignant tumor confirmed in the First Medical Center, Chinese PLA General Hospital between Jul. 2020 and May 2022. The data of 200 patients were selected for analysis and were divided into a ST-VATS group with 100 patients and a conventional T-VATS (CT-VATS) group; The operation time, intraoperative blood loss, number of dissected lymph nodes, 3d postoperative drainage volume, postoperative chest drainage time and postoperative complications were compared respectively between the groups.Results:There was no perioperative mortality and tumor-negative surgical margin in groups. The two groups were no statistically difference in intraoperative blood loss, number of dissected lymph nodes and 3 d postoperative drainage volume. As compared with the CT-VATS group, patients in the ST-VATS group demonstrated shorter operation time [(56.29±13.35) min vs. (63.78±14.91) min, P=0.001] and shorter postoperative chest drainage time [3(3) d vs. 5(4) d, P<0.0001], with statistical differences (P<0.05).Conclusion:Compared with CT-VATS lobectomy, the ST-VATS lobectomy has the advantages of shorter operation time and postoperative chest drainage time. Additionally, it achieves the same surgical outcomes, making it a safe, effective, and promotable surgical approach.
基金项目
首都临床特色诊疗技术研究及转化应用(Z221100007422124)
万方数据