单孔与两孔胸腔镜肺叶切除治疗肺癌的对比研究

发布时间：2018-03-18 10:06

本文选题：单孔　切入点：电视胸腔镜手术　出处：《中国微创外科杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的探讨单孔与两孔胸腔镜肺叶切除及系统性淋巴结清扫手术治疗肺癌的安全性和临床效果。方法选择2014年10月~2015年11月同一术者同期实施胸腔镜肺叶切除及系统性淋巴结清扫手术治疗的肺癌患者179例,单孔组86例,两孔组93例。回顾性比较2组手术时间、术中出血量、术后前3天引流量、胸腔引流时间、术中淋巴结清扫数目、淋巴结站数、术后住院时间、并发症、住院费用、术后第3天及术后1个月疼痛评分等。结果 2组手术均顺利完成,均无增加操作孔或中转开胸病例。2组手术时间、术中出血量、胸腔引流量、引流时间、术后住院时间、并发症及住院费用均无统计学差异(P0.05),2组淋巴结清扫数目、站数,N2组淋巴结清扫数目、站数亦均无统计学差异(P0.05)。单孔组术后第3天及术后1个月疼痛评分低于两孔组[术后3天(24.9±10.7)分vs.(32.9±17.6)分,t=-3.696,P=0.000;术后1个月(12.0±8.5)分vs.(17.3±12.3)分,t=-3.395,P=0.001]。结论单孔胸腔镜肺叶切除术能够很好地保护胸壁肌肉、肋间神经及血管,降低手术对机体的创伤,减轻术后疼痛,是一种安全、有效的肺癌根治性手术方式。
[Abstract]:Objective to investigate the safety and clinical effect of thoracoscopic lobectomy and systemic lymph node dissection in the treatment of lung cancer. Methods from October 2014 to November 2015, the same patients underwent thoracoscopic lobectomy and systemic lymphadenectomy. 179 patients with lung cancer treated by general lymph node dissection, 86 cases in single hole group and 93 cases in two-hole group. The operative time, intraoperative bleeding volume, drainage time, drainage time, number of lymph node dissection, number of lymph node stations, postoperative hospitalization time, complications were compared retrospectively. Results the operation was completed successfully in both groups, and there was no increase in operation time, intraoperative bleeding volume, thoracic drainage volume, drainage time in both groups. There was no significant difference in postoperative hospitalization time, complication and hospitalization cost. There was no significant difference in the number of lymph node dissection between the two groups (P 0.05) and the number of lymph node dissection in N 2 group (P 0.05). There was no significant difference in the number of stations in the single hole group. The pain score of the single hole group was lower than that of the two hole group on the 3rd day and 1 month after operation [3 days after operation, 24.9 卤10.7, vs.(32.9 卤17.6), and 1 month after operation, the score was 12.0 卤8.5 vs.(17.3 卤12.30.Conclusion the single hole thoracoscopic lobectomy is good. To protect the chest wall muscles, Intercostal nerve and blood vessel is a safe and effective radical operation for lung cancer.
【作者单位】：北京医院胸外科国家老年医学中心;
【分类号】：R734.2

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