摘要
目的分析Flex-三维胸腔镜肺叶切除及淋巴结清扫术治疗原发性肺癌的疗效及安全性。方法2017年1月~2020年6月拟行胸腔镜肺叶切除及淋巴结清扫术的原发性肺癌病人65例,按照随机数字表法分为对照组(32例)和观察组(33例),对照组采用二维胸腔镜肺叶切除术治疗,观察组采用Flex-三维胸腔镜肺叶切除治疗。比较两组病人淋巴结清扫数目、术后病理分期结果、手术结果和临床指标、术后视觉模拟疼痛评分(VAS)以及并发症发生情况。结果观察组淋巴结清扫数目为423枚,术后病理分期Ⅰ期29例,Ⅱ期3例,Ⅲ期1例;对照组淋巴结清扫数目为408枚,术后病理分期Ⅰ期25例,Ⅱ期4例,Ⅲ期3例。两组比较差异无统计学意义(P>0.05)。两组病人术中失血量比较无明显差异(P>0.05),观察组手术时间短于对照组,差异有统计学意义(P<0.05)。两组术后VAS评分随手术时间的推移逐次降低,观察组术后3天、1个月以及3个月的VAS评分均低于对照组,差异有统计学意义(P<0.05)。两组均无严重并发症及死亡病例,观察组肺不张发生率(3.03%)低于对照组(9.38%),但差异不明显(P>0.05)。结论Flex-三维胸腔镜肺叶切除及淋巴结清扫术治疗原发性肺癌疗效确切,通过三维立体还原解剖组织结构,提高手术清晰度和操作精准度,能缩短手术时间,减轻病人术后疼痛程度,且有较高的安全性。
Objective To analyze the efficacy and safety of Flex-three-dimensional thoracoscopic lobectomy and lymph node dissection in the treatment of primary lung cancer.Methods Sixty-five patients with primary lung cancer who planned to undergo thoracoscopic lobectomy and lymph node dissection in our hospital from January 2017 to June 2020 were selected and divided into control group(n=32)and observation group(n=33)according to the random number table method.The control group was treated with two-dimensional thoracoscopic lobectomy,and the observation group was treated with Flex-three-dimensional thoracoscopic lobectomy.The number of lymph node dissections,postoperative pathological staging results,surgical results and clinical indicators,postoperative visual analog pain score(VAS)and complications were compared and observed between the two groups.Results The number of lymph node dissections in the observation group was 423.The postoperative pathological staging was 29 cases in stageⅠ,3 cases in stage Ⅱ,and 1 case in stage Ⅲ.The number of lymph node dissection in the control group was 408.The postoperative pathological stages were 25 cases in stageⅠ,4 cases in stage Ⅱ,and 3 cases in stage Ⅲ.There was no significant difference in the results between the two groups(P>0.05).There was no significant difference in intraoperative blood loss between the two groups(P>0.05).The operation time of the observation group was shorter than that of the control group(P>0.05).The VAS scores of the two groups decreased gradually with the passage of operation time.The VAS scores of the observation group were lower than those of the control group at 3 days,1 month and 3 months after surgery(P<0.05).There were no serious complications and deaths in the two groups.The incidence of atelectasis in the observation group was lower than that in the control group(3.03%vs.9.38%,P>0.05).Conclusion Flex-three-dimensional thoracoscopic lobectomy and lymph node dissection are effective in the treatment of primary lung cancer.Through the three-dimensional restoration of the anatomical tissue structure,the clarity of the operation and the accuracy of the operation are improved,and it can effectively shorten the operation time,it can reduce the degree of postoperative pain and has high safety.
作者
周存荣
黄陈军
蔡强
ZHOU Cunrong;HUANG Chenjun;CAI Qiang(Department of Thoracic Surgery,Pukou Hospital,Jiangsu Province,Nanjing,211800 China;不详)
出处
《临床外科杂志》
2021年第8期717-720,共4页
Journal of Clinical Surgery
关键词
原发性肺癌
Flex-三维胸腔镜
二维胸腔镜
肺叶切除术
淋巴结清扫术
primary lung cancer
Flex-three-dimensional thoracoscopy
two-dimensional thoracoscopy
lobectomy
lymph node dissection
作者简介
通信作者:蔡强,Email:mixieery@126.com。
