摘要
目的:将近距离两孔胸腔镜下肺叶切除及系统性淋巴结清扫这种肺癌手术方式与单孔胸腔镜肺癌手术进行对比研究,比较其手术安全性、手术效果、术后疼痛等,以期为肺癌术式选择提供更多参考。方法:收集北京大学第一医院胸外科及北京医院胸外科2012年10月至2015年1月拟行肺癌根治性手术患者269例,纳入统计分析205例,近距离两孔法122例,单孔法83例,收集并比较围手术期各临床数据。结果 :两组患者术后均无死亡或严重并发症出现,在术中失血量、术后引流量及拔除胸腔闭式引流管时间、住院时间、术后疼痛和住院费用方面等指标比较差异没有统计学意义(P>0.05),手术时间、术中清扫淋巴结数目、术后并发症(主要是皮下气肿、引流管口漏气及伤口愈合不良)等方面近距离两孔法优于单孔法(P<0.05)。结论 :近距离两孔胸腔镜肺癌手术是安全可行的,疼痛方面与单孔法相同,手术操作难度和并发症少于单孔法。
Objective To compare the safety, surgery effects, pain scores of the close-distance-two-port video-assisted lobectomy and systematic dissection of the mediastinal nodes, and single-port video-assisted thoracoscopic surgery（VATS）. Methods Between October 2012 and January 2015 in Peking University First Hospital and Beijing Hospital, 269 patients who were going to be performed lobectomy and systematic lymph node dissection, were gathered and 205 patients were included in this study finally. Of the total, 122 patients were performed close-distance-two-port VATS, and 83 patients underwent single-port VATS. The clinical data were gathered, and statistically analyzed. Result In both groups, no severe postoperative complications or death occurred. No significant differences existed between the two groups in terms of intraoperative blood loss, duration and volume of chest tube drainage, postoperative pain score, hospital stay after surgery and hospitalization expenses（P〈0.05） but the data about operating time, number of dissected lymph nodes, complications（subcutaneous emphysema, air-leak from the port of drainage tube and poor wound healing） were significantly different（P〈0.05）. Conclusions Compared with the single-port VATS, the method of close-distance-two-port video-assistant lobectomy and systematic dissection of the mediastinal nodes is safe and practicable with definite therapeutic effect, less operation difficulty and complications.
出处
《实用医学杂志》
CAS
北大核心
2016年第10期1627-1630,共4页
The Journal of Practical Medicine
关键词
肺肿瘤
肺叶切除术
两孔胸腔镜
单孔胸腔镜
Video-assisted thoracic surgery
Two ports VATS
Lung cancer
Lobectomy
