Objective To analyze the effects of single-port video-assisted thoracoscopic surgery (VATS) on perioperative indicators and pulmonary function in patients with pulmonary nodules. Methods A total of 80 patients with pulmonary nodules admitted to the Coast Guard Hospital from January 2021 to October 2022 were divided into a control group and an observation group based on the surgical method, with 40 cases in each group. The control group was treated with conventional multi-port VATS, while the observation group underwent single-port VATS. The perioperative indicators, pulmonary function, immune function and oxidative stress markers were compared between the two groups. Results After treatment, the operative duration, intraoperative blood loss, total volume of postoperative drainage fluid, postoperative pain score, duration of postoperative closed thoracic drainage, and total hospitalization cost in the observation group were superior to those in the control group (P<0.05), but no statistically significant difference was observed in the hospital stay between the two groups. Compared with preoperative values, postoperative measurements in the observation group showed a decrease in maximum voluntary ventilation (MVV), forced vital capacity (FVC), and forced expiratory volume in the first second (FEV1). No significant differences in MVV or FVC were observed between the two groups after treatment, but the FEV1 in the observation group(1.65±0.39)L was higher than that in the control group (1.39±0.57)L, with statistically significant differences (P<0.05). Compared with pre-treatment levels, the relative expression levels of nicotinamide adenine dinucleotide phosphate oxidase 2 (NOX2) and nicotinamide adenine dinucleotide phosphate oxidase 4 (NOX4) increased, while immunoglobulin M (IgM) and immunoglobulin A (IgA) decreased in both groups after treatment. The relative expression levels of NOX2 and NOX4 in the observation group after treatment were lower than those in the control group, while the levels of IgM and IgA in the observation group were higher than those in the control group, with statistically significant differences (P<0.05). Conclusions Compared with conventional multi-port VATS, single-port VATS resulted in better perioperative indicators, as well as significant improvements in pulmonary function, immune function, and oxidative stress indicators in patients with pulmonary nodules, demonstrating high clinical application value.
Key words
pulmonary nodules /
single-port thoracoscopic surgery /
pulmonary function /
perioperative indicators /
immune function and oxidative stress indicators
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References
[1] 张道忠,王树军,曹 亮.老年恶性孤立性肺结节患者电视胸腔镜手术治疗预后的影响因素[J].中国老年学杂志,2022,42(13):3204-3207.
[2] 王 义,解明然,王树军,等.电视胸腔镜手术与开胸手术在肺部结节诊治中的效果对比[J].中华全科医学, 2019,17(7):1115-1117.
[3] 陈 宇,宁光耀,夏万里,等.单孔胸腔镜在治疗孤立性肺结节中的应用[J].临床肺科杂志,2018,23(11): 2038-2040.
[4] 中华医学会呼吸病学分会肺癌学组,中国肺癌防治联盟专家组.肺部结节诊治中国专家共识[J].中华结核和呼吸杂志,2015,38(4):249-254.
[5] Scott J,Huskisson E C.Graphic representation of pain[J].Pain,1976,2(2):175-184.
[6] 王 君,张天赐,魏大中.单孔胸腔镜肺段切除术治疗肺结节118例[J].中国微创外科杂志,2020,20(11):991-994.
[7] 金天英,徐朱慧,邬冬强.单孔胸腔镜治疗肺结节术后肺部并发症发生的影响因素分析[J].江苏医药,2021,47(3):251-255.
[8] Zhu Y,Liang M,Wu W,et al. Preliminary results of single-port versus triple-port complete thoracoscopic lobectomy for non-small cell lung cancer[J].Ann Transl Med,2015,3(7):92-99.
[9] Ji C,Xiang Y,Pagliarulo V,et al.A multi-center retrospective study of single-port versus multi-port video-assisted thoracoscopic lobectomy and anatomic segmentectomy[J].J Thorac Dis,2017,9(10):3711-3718.
[10] 朱金美,汪 涛.单孔胸腔镜手术治疗肺结节的临床疗效[J].安徽医学,2021,42(7):740-743.
[11] Zuo X,Liu G,Liu X,et al.Effect and feasibility of uniportal thoracoscopic surgery in the treatment of early-stage lung cancer in a primary hospital[J]. Transl Cancer Res,2021,10(7):3507-3515.
[12] Guo X,Liu D,Shao Z,et al.Safety, efficacy, and postoperative pulmonary function recovery of uniportal and multiportal thoracoscopic lung segmentectomy[J]. J Thorac Dis,2025,17(5):3118-3127.
[13] 叶 超,陈平伟,覃家锦,等.单孔胸腔镜与两孔胸腔镜手术治疗非小细胞肺癌的手术相关指标和实验室指标比较[J].临床和实验医学杂志,2020,19(3):317-320.
[14] Vermot A,Petit-Härtlein I,Smith S M,et al.NADPH oxidases (NOX): an overview from discovery, molecular mechanisms to physiology and pathology[J].Antioxidants,2021,10(6):890-899.
[15] Beyer H,Sommerfeld M,Grandien K,et al.Functional studies with IgM and IgA immunoglobulins: binding to pIgR, FcαμR, FcμR, and CDC activities[J]. APMIS,2024,132(4):277-288.
[16] Liang S,Yin X,Fu Y,et al.Comparison of inflammatory cytokine levels between single-port and three-port thoracoscopic lobectomy in the treatment of non-small-cell lung cancer[J].Biomed Res Int,2022:3240252.
[17] Hu C G,Zheng K,Liu G H,et al.Effectiveness and postoperative pain level of single-port versus two-port thoracoscopic lobectomy for lung cancer: a retrospective cohort study[J].Gen Thorac Cardiovasc Surg,2021,69(2):318-325.
[18] 王小卫,濮忠建,包军军,等.单孔、两孔及三孔胸腔镜下肺叶切除术对老年早期非小细胞肺癌的临床疗效及对氧化应激的影响[J].中国医药导报,2024,21(2):124-127,131.
[19] 陈大庆,詹必成,陈 剑.单孔胸腔镜下肺叶解剖切除术对早期非小细胞肺癌的疗效及安全性分析[J].中国肿瘤外科杂志,2020,12(3):203-207.
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