目的比较单孔和三孔胸腔镜肺叶切除术治疗非小细胞肺癌的围术期结果。方法计算机检索PubMed、Web of Science、EMbase、知网、万方数据库,检索时限为建库至2022年4月。由两名研究人员独立进行文献筛选、数据提取和偏倚风险评价,利用RevM...目的比较单孔和三孔胸腔镜肺叶切除术治疗非小细胞肺癌的围术期结果。方法计算机检索PubMed、Web of Science、EMbase、知网、万方数据库,检索时限为建库至2022年4月。由两名研究人员独立进行文献筛选、数据提取和偏倚风险评价,利用RevMan 5.3和Stata 16.0进行数据分析。使用Cochrane偏倚风险评估工具评价纳入研究的偏倚风险。结果共纳入18篇随机对照研究,共计1597例患者,其中800例患者进行了单孔胸腔镜肺叶切除术(单孔组),797例患者进行了三孔胸腔镜肺叶切除术(三孔组)。Meta分析结果显示:相较于三孔组,单孔组手术时间更长[WMD=7.63,95%CI(2.36,12.91),P=0.005],但术中出血量少于三孔组[WMD=–28.81,95%CI(–42.54,–15.08),P<0.001]。术后指标方面,单孔组患者术后24 h内疼痛视觉模拟评分更低[WMD=–1.60,95%CI(–2.26,–0.94),P<0.001]、术后胸腔引流量少于三孔组[WMD=–25.30,95%CI(–46.22,–4.37),P=0.020]、术后胸腔引流管留置时间较短[WMD=–0.36,95%CI(–0.72,–0.01),P=0.040]。单孔组患者住院时间明显缩短[WMD=–2.28,95%CI(–2.68,–1.88),P<0.001]、术后并发症发生率低于三孔组[RR=0.49,95%CI(0.38,0.63),P<0.001]。两种术式在清扫淋巴结数量上差异无统计学意义[WMD=–0.01,95%CI(–0.24,0.21),P=0.930]。结论单孔与三孔胸腔镜肺叶切除术治疗非小细胞肺癌同样安全可行,单孔胸腔镜在减轻术后早期疼痛、降低术后并发症发生率和缩短住院时间方面具有优势。展开更多
Objective:To study the differences in the body pain and trauma degree between uniportal and three-portal video-assisted thoracoscopic surgery for the treatment of lung cancer.Methods:A total of 108 patients with non-s...Objective:To study the differences in the body pain and trauma degree between uniportal and three-portal video-assisted thoracoscopic surgery for the treatment of lung cancer.Methods:A total of 108 patients with non-small cell lung cancer who received radical operation in our hospital between February 2013 and February 2016 were selected and divided into the uniportal group (n=52) who received uniportal video-assisted thoracoscopic surgery and the three-portal group (n=56) who received three-portal video-assisted thoracoscopic surgery after the operation methods and related laboratory results were reviewed. Before operation and 24 h after operation, the differences in serum levels of pain mediators, oxidative stress indexes and inflammation indexes were compared between the two groups of patients.Results: Before operation, the differences in serum levels of pain mediators, oxidative stress indexes and inflammation indexes were not statistically significant between the two groups of patients. 24 h after operation, serum pain mediators NE, DA and 5-HT levels of observation group were lower than those of control group;oxidative stress indexes MDA and O2- levels were lower than those of control group while SOD and GSH-Px levels were higher than those of control group;inflammation indexes IL-6, IL-8, CRP and TNF-α levels were lower than those of control group.Conclusion: Uniportal video-assisted thoracoscopic surgery for the treatment of lung cancer causes less surgery trauma, and patients' postoperative pain and systemic inflammatory stress response are lighter.展开更多
基金Projects of Natural Science Foundation of China No:81373941.
文摘Objective:To study the differences in the body pain and trauma degree between uniportal and three-portal video-assisted thoracoscopic surgery for the treatment of lung cancer.Methods:A total of 108 patients with non-small cell lung cancer who received radical operation in our hospital between February 2013 and February 2016 were selected and divided into the uniportal group (n=52) who received uniportal video-assisted thoracoscopic surgery and the three-portal group (n=56) who received three-portal video-assisted thoracoscopic surgery after the operation methods and related laboratory results were reviewed. Before operation and 24 h after operation, the differences in serum levels of pain mediators, oxidative stress indexes and inflammation indexes were compared between the two groups of patients.Results: Before operation, the differences in serum levels of pain mediators, oxidative stress indexes and inflammation indexes were not statistically significant between the two groups of patients. 24 h after operation, serum pain mediators NE, DA and 5-HT levels of observation group were lower than those of control group;oxidative stress indexes MDA and O2- levels were lower than those of control group while SOD and GSH-Px levels were higher than those of control group;inflammation indexes IL-6, IL-8, CRP and TNF-α levels were lower than those of control group.Conclusion: Uniportal video-assisted thoracoscopic surgery for the treatment of lung cancer causes less surgery trauma, and patients' postoperative pain and systemic inflammatory stress response are lighter.
