目的 比较单孔胸腔镜和多孔胸腔镜肺癌手术的临床疗效。方法 选取2015-08至2017-10收治的肺癌患者132例,分为单孔组和多孔组。单孔组采取腋中线第5肋间约3 cm切口完成手术操作。多孔组则方便完成手术,不限操作孔数目。通过视觉模拟疼痛评分(VAS)评估疼痛来比较术后疼痛。比较手术时间、术中出血量、术后胸腔引流量、住院时间、术后并发症发生率等指标。结果 单孔组手术时间多于多孔胸腔镜组,差异具有统计学意义(P<0.05)。两组的术后引流量、引流管留置时间、住院时间、术中出血量、淋巴结清扫数量比较,差异无统计学意义。两组术后第1天VAS评分无统计学差异;单孔组术后第3、5、7天的VAS评分(3.91±0.39,3.04±0.13,1.53±0.09)低于多孔组(5.78±0.48,4.41±0.19,2.72±0.15),差异具有统计学意义(P<0.05);单孔组术后并发症发生率(22.2％)和多孔组(21.7％)比较,差异无统计学意义。结论 单孔胸腔镜术后疼痛缓解更快,利于术后恢复。术后并发症的控制和淋巴结清扫能达到相同的临床效果。手术时间长,需要熟练配合来减少。
Abstract
Objective To compare the clinical outcomes between uniportal video-assisted thoracoscopic surgery (VATS) and multiportal VATS for NSCLC.Methods The clinical data on 132 patients with NSCLC treated between August 2015 and October 2017 was retrospectively analyzed. All the patients were divided into two groups: the uniportal VATS group and multiportal VATS group. In the first group, a single incision was completed through the fifth intercostal space in the axillary midline while the second group had a number of incisions as required. Postoperative pain was compared using the visual analogue pain scale (VAS). The clinical effects were compared with reference to the duration of surgery, the amount of perioperative bleeding, thoracic drainage volume, postoperative hospital stay and postoperative complications.Results All the operations were successful in 132 cases and no one died perioperatively. The duration of surgery of the uniportal VATS group was longer than that of the latter (P<0.05). There was no significant difference in the postoperative drainage volume, duration of drainage, postoperative hospital stay, operative blood loss or lymph node dissection. The VAS on the first postoperative day was not significantly different between the two groups, but was lower in the uniportal group on postoperative third, fifth, seventh days (3.91±0.39,3.04±0.13,1.53±0.09) than in the multiportal group(5.78±0.48,4.41±0.19,2.72±0.15) (P<0.05). There was no significant difference in postoperative complications between the two groups (22.2% versus 21.7%).Conclusions Uniportal VATS can help alleviate postoperative pain and recovery. Uniportal VATS is as effective as multiportal VATS for managing complications and removing lymph nodes.
关键词
单孔胸腔镜 /
术后并发症 /
非小细胞肺癌 /
视觉模拟疼痛评分
Key words
uniportal video-assisted thoracoscopic surgery /
visual analogue scale /
non-small-cell lung cancer /
visual analogue pain scale
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