单孔、两孔及三孔胸腔镜下早期非小细胞肺癌根治术的效果比较研究

目的:通过比较不同胸腔镜手术方式治疗早期非小细胞肺癌根治术术后的相关临床指标,为临床手术方式提供经验。方法:收集我院2017年1月～2019年12月收治的行肺癌根治术的早期非小细胞肺癌病例共100例,分别采用单孔胸腔镜(40例),两孔胸腔镜(32例)及三孔胸腔镜(28例)手术方式,比较三组手术术中及术后的相关指标。结果:单孔胸腔镜组术中出血量、术后引流量明显少于两孔胸腔镜组和三孔胸腔镜组(P0.05),而两孔胸腔镜组明显少于三孔胸腔镜组(P0.05);单孔胸腔镜组术后胸管留置时间和术后住院时间均短于两孔胸腔镜组和三孔胸腔镜组(P0.05),而两孔胸腔镜组明显短于三孔胸腔镜组(P0.05)。三组组内疼痛评分术后24h低于术后12h,术后48h低于术后24h,差异均有统计学意义(P0.05)。三组组间不同时间点疼痛评分比较发现,单孔胸腔镜组疼痛评分低于两孔胸腔镜组和三孔胸腔镜组(P0.05),而两孔胸腔镜组低于三孔胸腔镜组(P0.05)。三组清扫淋巴结数目、淋巴结站数和术后并发症发生率差异均无统计学意义(P0.05)。结论:单孔胸腔镜早期非小细胞肺癌根治术与两孔、三孔胸腔镜手术相比优势明显,且不会显著增加术后并发症,可作为临床首选。

Comparative Study on the Effect of Single, Two, and Three Hole Thoracoscopic Resection for Early Non-small Cell Lung Cancer

ABSTRACT Objective: To provide experience for clinical operation,we compared the clinical indexes of different thoracoscopic operation methods in the treatment of early non-small cell lung cancer after radical operation. Methods: From January 2017 to December 2019, a total of 100 patients with early non-small cell lung cancer who underwent radical resection of lung cancer in our hospital were collected. Single hole thoracoscopy (40 cases), two hole thoracoscopy (32 cases) and three hole thoracoscopy (28 cases) were used,and compared the intraoperative and postoperative indicators of the three groups. Results: The intraoperative blood loss and postoperative thoracic drainage in the single hole group were significantly less than those in the two hole group and the three hole group (P<0.05), while those in the two hole group were significantly less than those in the three hole group (P<0.05); the postoperative chest tube indwelling time and postoperative hospital stay in the single hole group were shorter than those in the two hole group and the three hole group (P<0.05), while those in the two hole group were significantly shorter than those in the three hole group (P<0.05). The pain score at postoperative 24h of the three groups was lower than postoperative 12h, and postoperative 48h lower than postoperative 24h, the difference was statistically significant (P<0.05). The results showed that the pain score of single hole group was lower than that of two hole group and three hole group (P<0.05), while two hole group was lower than three hole group (P<0.05). There was no significant difference in the number of lymph nodes, the number of lymph node stations and the incidence of postoperative complications between three groups (P>0.05). Conclusion: Compared with two hole and three hole thoracoscopic surgery, single hole thoracoscopic surgery for early non-small cell lung cancer has obvious advantages,and does not significantly increase postoperative complications, so it can be used as the clinical first choice.