摘要
目的对比并探讨电视辅助小切口胸腔镜肺叶切除术（VAMT）、杂交式单孔操作电视胸腔镜肺叶切除术手术（HSHVATS）、多孔操作电视胸腔镜肺叶切除术（PVATS）治疗非小细胞肺癌（NSCLC）的围术期疗效。方法回顾性分析2011年6月~2014年8月间胸外科收治的行胸腔镜手术治疗的150例NSCLC患者,根据手术方式的不同分为VAMT组48例、HSHVATS组50例、PVATS组52例,比较三组患者切口长度、术中失血量、手术时间、引流时间、淋巴结清扫数量、术后总引流量、围术期并发症等指标。结果三组患者手术均顺利完成,无围术期死亡病例。HSHVATS组患者切口长度（4.2±0.7）cm、术中出血量（166.6±685）ml、胸引管留置时间（5.9±2.8）d,均显著低于VAMT组（11.4±2.5）cm、（287.1±99.7）ml、（7.7±3.4）min（P〈0.05）,两组手术时间、术后总引流量、淋巴结清扫数差异均无统计学意义（P〉0.05）;PVATS组患者切口长度（4.1±0.9）cm、术中出血量（178.8±74.2）ml均显著低于VAMT组患者（P〈0.05）,两组手术时间、术后总引流量、胸引管留置时间、淋巴结清扫数量差异均无统计学意义（P〉0.05）;HSHVATS组和PVATS组在切口长度、手术时间、术中出血量、术后总引流量、胸引管放置时间、淋巴结清扫数目等围术期指标方面比较均无显著性差异（P〉0.05）。三组术后并发症发生率（8.3%vs.4.0%、9.6%）差异无统计学意义（Z=-0.223 P=0.824）。结论早期NSCLC通过VAMT、HSHVATS、PVATS肺叶切除术联合系统性纵隔淋巴结清扫术治疗均有效且安全,肿瘤切除均彻底;HSHVATS和PVATS较VAMT具有出血少、创伤小、术后恢复快等特点,HSHVATS较PVATS具有切口小、操作简单,对术者要求更低的临床优势。
Objective To compare and discuss the operative efficacy of video-assisted mini-thoracotomy（ VAMT）,hybrid single-hole video-assisted thoracoscope surgery（ HSHVATS）,and porous video-assisted thoracoscope lung resection（ PVATS） in the treatment of early non-small cell lung cancer（ NSCLC）. Methods A retrospective analysis was conducted on 150 patients with early NSCLC underwent thoracoscopic surgery from Jun. 2011 to Dec. 2014 in our hospital,who were divided into the VAMT group（ 48 cases）,the HSHVATS group（ 50 cases）,and the PVATS group（ 52 cases） according to different thoracoscopic surgery. Incision length,intraoperative blood loss,operation time,drainage time,lymph node cleaning numbers,total drainage volume and postoperative complications were comparatively analyzed among the 3 groups. Results All patients were successfully completed resection surgery,and there was no perioperative death reported. In the HSHVATS group,the incision length was（ 4. 2 ＋ 4. 2）cm,the intraoperative blood loss was（ 166. 6 ＋ 68. 5） ml,and the chest tube indwelling time was（ 5. 9 ＋ 2. 8） d,which were all significantly lower than those of the VAMT group [（ 11. 4 ＋ 2. 5） cm,（ 287. 1 ＋ 99. 7） ml,（ 7. 7 ~3. 4） min]（ P〈0. 05）. There was no significant difference in operation time,lymph node cleaning numbers and total drainage volume between the HSHVATS group and the VAMT group（ P〉0. 05）. In the PVATS group,the incision length was（ 4. 1 ＋ 4. 1） cm,the intraoperative blood loss was（ 178. 8 ＋ 74. 2） ml,which were significantly lower those of the VAMT group（ P〉0. 05）. There was no significant in operation time,total drainage volume and chest tube indwelling time between the PVATS group and the VAMT group（ P〉0. 05）. There was no significant difference in incision length,operative time,intraoperative blood loss,total drainage volume,chest tube indwelling time,number of lymph node cleaning between the HSHVATS group and the PVATS group（ P〈0. 05）. T
出处
《临床肺科杂志》
2016年第2期327-331,共5页
Journal of Clinical Pulmonary Medicine
关键词
电视胸腔镜手术
非小细胞肺癌
肺叶切除术
手术效果
并发症
video-assisted thoracoscope surgery
non-small cell lung cancer
lung resection
operative efficacy
complications
