摘要
目的比较经剑突下单孔胸腔镜(SUVATS)与经肋间单孔胸腔镜(IUVATS)肺叶切除术治疗非小细胞肺癌的效果。方法纳入2019年7月1~31日于上海市肺科医院胸外科行单孔胸腔镜肺叶切除的428例非小细胞肺癌患者,按术式不同,将患者分为SUVATS组[80例,男42例、女38例,年龄(58.8±9.6)岁]和IUVATS组[348例,男161例、女187例,年龄(61.2±10.0)岁]。比较两组的临床效果。结果两组患者在性别(P=0.314)、年龄(P=0.052)、术前肺功能(P=0.701)、慢性合并症(合并心血管疾病,P=0.775;合并慢性阻塞性肺疾病,P=0.678)和术后病理类型(P=0.132)等方面差异无统计学意义。与IUVATS组比较,SUVATS组手术时间更长[(155.6±34.4)min vs.(141.3±27.0)min,P<0.001],术中出血量较少[(165.2±160.6)mL vs.(223.7±272.4)mL,P<0.001],置管时间更短[(4.3±2.0)d vs.(4.9±1.9)d,P=0.011];术后8 h(P<0.001)、1 d(P=0.019)、2 d(P=0.015)和出院前1 d(P<0.001)疼痛评分较低。结论采用SUVATS行肺叶切除安全有效,术后疼痛减轻,可有效促进患者快速康复。
Objective To investigate the effects of subxiphoid uniportal video-assisted thoracoscopic surgery(SUVATS)and intercostal uniportal VATS(IUVATS)in lobectomy for non-small cell lung cancer(NSCLC).Methods A total of 428 patients with NSCLC who underwent lobectomy via SUVATS or IUVATS from July 1 st to 31 st,2019 in Shanghai Pulmonary Hospital were enrolled.Patient characteristics,perioperative outcomes and postoperative pain scores at different time points were collected.The patients were divided into a SUVATS group(80 patients,42 males and 38 females with an average age of 58.8±9.6 years)and an IUVATS group(348 patients,161 males and 187 females,with an average age of 61.2±10.0 years).The clinical effectiveness of the two groups was compared.Results There was no significant difference in sex(P=0.314),age(P=0.052),preoperative pulmonary function(P=0.701),combined chronic comorbidities(chronic cardiovascular disease,P=0.775;chronic obstructive pulmonary disease,P=0.678)and postoperative pathology(P=0.132)between the two groups.Compared with the IUVATS group,patients in the SUVATS group had longer operation time(155.6±34.4 min vs.141.3±27.0 min,P<0.001),less intraoperative blood loss(165.2±160.6 mL vs.223.7±272.4 mL,P<0.001),shorter time of chest tube use(4.3±2.0 d vs.4.9±1.9 d,P=0.011)and less postoperative pain score at different time points(postoperative 8 h,P<0.001;postoperative day 1,P=0.019;postoperative day 2,P=0.015;the day before discharge,P<0.001).Conclusion SUVATS is a safe and effective technique for lobectomy in NSCLC patients with less postoperative pain and can promote postoperative recovery.
作者
严晟
姜超
YAN Sheng;JIANG Chao(Department of Operating Room,Shanghai Pulmonary Hospital,Tongji University,Shanghai,200433,P.R.China;Department of Thoracic Surgery,Shanghai Pulmonary Hospital,Tongji University,Shanghai,200043,P.R.China)
出处
《中国胸心血管外科临床杂志》
CAS
CSCD
2020年第4期446-449,共4页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
基金
2019年上海市肺科医院院级人才计划(HL1907)。
关键词
电视辅助胸腔镜手术
经剑突下单孔
经肋间单孔
疼痛评分
非小细胞肺癌
Video-assisted thoracoscopic surgery
subxiphoid uniport
intercostal uniportal
pain score
non-small cell lung cancer
作者简介
通信作者:严晟,Email:m13641975720@163.com。
