中国医科大学学报

中国医科大学学报
  • 中文核心期刊
  • 中国科技核心期刊
  • 中国高校百佳科技期刊
  • BA、CA收录

中国医科大学学报 ›› 2018, Vol. 47 ›› Issue (7): 609-611,616.doi: 10.12007/j.issn.0258-4646.2018.07.009

• 论著 • 上一篇    下一篇

单孔与三孔胸腔镜肺叶切除术治疗周围型肺癌的临床疗效比较

石岱旺, 徐然, 韩云, 石文君   

  1. 中国医科大学附属盛京医院胸外科, 沈阳 110004
  • 收稿日期:2018-03-21 出版日期:2018-07-30 发布日期:2018-07-03
  • 通讯作者: 徐然 E-mail:114882436@qq.com
  • 作者简介:石岱旺(1987-),男,医师,硕士.
  • 基金资助:
    辽宁省科学技术计划(201601121)

Comparison of Efficacy Using Single-port and Three-port Thoracoscopic Lobectomy in Patients with Peripheral Lung Cancer

SHI Daiwang, XU Ran, HAN Yun, SHI Wenjun   

  1. Department of Thoracic Surgery, Shengjing Hospital, China Medical University, Shenyang 110004, China
  • Received:2018-03-21 Online:2018-07-30 Published:2018-07-03

摘要: 目的 比较单孔与三孔胸腔镜肺叶切除术治疗周围型肺癌的临床疗效。方法 选取行胸腔镜肺叶切除术的周围型肺癌患者176例,其中单孔组80例,三孔组96例,比较2组患者的手术时间、术中出血量、淋巴结清扫枚数、术后拔管时间、术后住院天数、切口长度、术后疼痛评分及并发症发生率等。结果 单孔组在手术时间、术后拔管时间、术后住院天数方面要长于三孔组,而单孔组在切口长度、术后疼痛评分方面要优于三孔组,2组差异均有统计学意义(P < 0.05)。单孔组与三孔组术中出血量、淋巴结清扫枚数及术后总并发症发生率比较,差异无统计学意义(P > 0.05),但2组术后胸腔积液的并发症发生率存在差异有统计学意义(P < 0.05)。结论 单孔与三孔胸腔镜肺叶切除术临床效果基本相当,是安全有效的。单孔胸腔镜肺叶切除术可缩短切口长度,外表美观,术后患者疼痛减轻,有利于患者的术后恢复,值得临床上推广。

关键词: 肺癌, 肺叶切除术, 单孔胸腔镜, 三孔胸腔镜, 胸腔镜

Abstract: Objective To compare the efficacy of single-port and three-port thoracoscopic lobectomy in patients with peripheral lung cancer. Methods A total of 176 patients with peripheral lung cancer were divided into single-port(n=80) and three-port groups(n=96). Clinical data, including operative time, intraoperative blood loss, number of lymph nodes dissected, postoperative extubation time, postoperative hospitalization, length of incision, postoperative pain score, and incidence of postoperative complications were compared between the two groups. Results In the single-port group, operative time, postoperative extubation time, and postoperative hospitalization were significantly longer than in the three-port group;however, the incision was shorter and the postoperative pain score was significantly lower than in the three-port group (P < 0.05). There were no significant differences in intraoperative blood loss, number of lymph nodes dissected, and incidence of postoperative complications between the two groups(P > 0.05). However, the incidence of postoperative pleural effusion was higher in the single-port group than in the three-port group(P < 0.05). Conclusion The clinical efficacy of single-port and three-port thoracoscopic lobectomy for peripheral lung cancer is basically the same, and both were safe and effective. Single-port thoracoscopic lobectomy can shorten the incision length, improve scar appearance, and reduce postoperative pain, and is beneficial for postoperative recovery. This technique should be promoted.

Key words: lung cancer, lobectomy, single-hole thoracoscope, three-hole thoracoscope, thoracoscope

中图分类号: 

  • R734
[1] GONZALEZ-RIVAS D,DE LA TORRE M,FERNANDEZ R,et al. Video:single incision video assisted thoracoscopic right pneumonectomy[J].Surg Endosc,2012,26(7):2078-2079. DOI:10.1007/s00464-011-2127-x.
[2] SAKURABA M,MIYAMOTO H,OH S,et al. Video-assisted thoracoscopic lobectomy vs conventional lobectomy via open thoracotomy in patients with clinical stage ⅠA non-small cell lung carcinoma[J]. Interact Cardiovasc Thorac Surg,2007,6(5):614-617. DOI:10.1510/icvts.2007.157701.
[3] TOMASZEK SC,CASSIVI SD,SHEN KR,et al. Clinical outcomes of video-assisted thoracoscopic lobectomy[J]. Mayo Clin Proc,2009,84(6):509-513. DOI:10.1016/S0025-6196(11)60582-X.
[4] CHEN FF,ZHANG D,WANG YL,et al. Video-assisted thoracoscopic surgery lobectomy versus open lobectomy in patients with clinical stage non-small cell lung cancer:a meta-analysis[J]. Eur J Surg Oncol,2013,39(9):957-963.DOI:10.1016/j.ejso.2013.06.016.
[5] LUH SP,LIU HP. Video-assisted thoracic surgery-the past,present status and the future[J]. J Zhejiang Univ Sci B,2006,7(2):118-128. DOI:10.1631/jzus.2006.B0118.
[6] 杨博,初向阳,戴为民,等.三种胸腔镜下肺叶切除术的手术方法及结果比较[J].解放军医学杂志,2013,40(11):913-916. DOI:10.11855/j.issn.0577-7402.2013.11.101.
[7] ROCCO G,MARTIN-UCAR A,PASSERA E.Uniportal VATS wedge pulmonary resections[J]. Ann Thorac Surg,2004,77(2):726-728. DOI:10.1016/S0003-4975(03)01219-0
[8] GONZALEZ D,PARADELA M,GARCIA J,et al. Single-port video-assisted thoracoscopic lobectomy[J]. Interact Cardiovasc Thorac Surg,2011,12(3):514-515. DOI:10.1510/icvts.2010.256222.
[9] GONZALEZ-RIVAS D,FIEIRA E,DELGADO M,et al. Uniportal video-assisted thoracoscopic lobectomy[J]. J Thorac Dis,2013,5(Suppl 3):S234-S245. DOI:10.3978/j.issn.2072-1439.2013.07.30.
[10] 李洋,张科伟,高新亮,等. 单孔电视辅助胸腔镜肺叶切除术20例[J].中华胸心血管外科杂志,2014,30(9):566-567. DOI:10.3760/cma.j.issn.1001-4497.2014.09.016
[11] 鲍熠,周逸鸣,杨倍,等. 单孔全胸腔镜下肺叶切除术5例[J]. 中华胸心血管外科杂志,2013,29(8):493-494. DOI:10.3760/cma. j.issn.1001-4497.2013.08.015.
[12] WANG BY,LIU CY,HSU PK,et al. Single-incision versus multipleincision incision thoracoscopic lobectomy and segmentectomy:a propensitymatched analysis[J]. Ann Surg,2015,261(4):793-799. DOI:10.1097/SLA.0000000000000712.
[13] TAMURA M,SHIMIZU Y,HASHIZUME Y. Pain following thoracoscopic surgery:retrospective analysis between single-incision and threeport video-assisted thoracoscopic surgery[J]. J Cardiothorac Surg,2013,12(8):153. DOI:10.1186/1749-8090-8-153.
[14] RAMI-PORTA,R,WITTEKIND C,GOLDSTRAW P,et al.Complete resection lung cancer surgery:proposed definition[J]. Lung Cancer, 2005,49(1):25-33. DOI:10.1016/j.lungcan.2005.01.001.
[1] 管超, 于莉, 徐兆国, 崔国元, 张晓晔. 小细胞肺癌免疫治疗的研究进展[J]. 中国医科大学学报, 2018, 47(8): 740-743,747.
[2] 王倩文, 徐振华, 王志静, 苏荣健, 陈学军, 谷艳娇. 葡萄糖调节蛋白78对L858R突变的非小细胞肺癌erlotinib敏感性的影响[J]. 中国医科大学学报, 2018, 47(8): 701-704.
[3] 张苏宁, 刘宗昂. 小细胞肺癌中DBC1的表达及预后相关性研究[J]. 中国医科大学学报, 2018, 47(3): 222-225.
[4] 贡鸣, 何天宇, 裘敬平, 李光. 6种常见肿瘤患者初治时外周血T淋巴细胞亚群数量及临床特征[J]. 中国医科大学学报, 2018, 47(12): 1119-1122.
[5] 赵轲, 张永建, 刘奇, 徐迪, 陈宝钧. miR-107与非小细胞肺癌的临床病理特征及预后的关联[J]. 中国医科大学学报, 2018, 47(10): 933-938.
[6] 金波,刘云鹏. 老年小细胞肺癌的治疗进展[J]. 中国医科大学学报, 2017, 46(8): 750-753.
[7] 解世林 ,曲晶磊 ,范一博 ,车晓芳 ,侯科佐 ,曲秀娟 ,刘云鹏 ,王晓楠 ,康健 ,胡雪君. Akt 和 SRC 在 Exosomes 促进同源肺癌细胞增殖中的作用[J]. 中国医科大学学报, 2017, 46(6): 481-484.
[8] 周立霞,吴月明,李娜. 色素上皮源性因子通过血管内皮生长因子抑制 非小细胞肺癌的发生发展[J]. 中国医科大学学报, 2017, 46(5): 422-424.
[9] 于溪 ,张彬彬 ,杨碧洁 ,张哲 ,马铭霞 ,邹佳运 ,赵明芳. 乳酸脱氢酶和神经元特异性烯醇化酶水平与广泛期小细胞肺癌 预后的关系[J]. 中国医科大学学报, 2017, 46(5): 425-428.
[10] 李向敏,许瑶琳,于莉,齐晓莹,蒋中秀,张晓晔. 52 例小细胞肺癌免疫组化表型的临床特点分析[J]. 中国医科大学学报, 2017, 46(5): 460-462.
[11] 解世林 ,曲晶磊 ,范一博 ,车晓芳 ,侯科佐 ,曲秀娟 ,刘云鹏 ,王晓楠 ,康健 ,胡雪君. Akt 和 SRC 在 Exosomes 促进同源肺癌细胞迁移中的作用[J]. 中国医科大学学报, 2017, 46(4): 294-297.
[12] 王哲 ,于海建 ,孙玉秀 ,秦宝丽. 肺癌患者乐观、韧性与焦虑的相关性分析[J]. 中国医科大学学报, 2017, 46(3): 238-240.
[13] 王煜东,刘军,张苏宁. 单孔胸腔镜手术在老年患者肺切除术中的应用[J]. 中国医科大学学报, 2017, 46(3): 241-243.
[14] 于溪 ,张彬彬 ,于溪 ,杨碧洁 ,张哲 ,马铭霞 ,邹佳运 ,赵明芳. 血红蛋白和胆红素水平与广泛期小细胞肺癌预后的关系[J]. 中国医科大学学报, 2017, 46(2): 112-115.
[15] 曲耘 ,吴荣 ,张晓晔. NF-κB/p65 siRNA 对小鼠 Lewis 肺癌移植瘤细胞凋亡和Bax 表达的影响[J]. 中国医科大学学报, 2017, 46(2): 145-148.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!

中国医科大学学报版权所有©2018

未经允许,严禁擅自转载本站图文资料

地址:中国 沈阳市沈北新区蒲河路77号 110122

辽ICP备05014850

JOURNAL OF CHINA MEDICAL UNIVERSITY

ADDRESS: NO.77 PUHE ROAD

SHENYANG NORTH NEW AREA, SHENYANG

LIAONING PROVINCE, P.R. CHINA