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目的探讨单操作孔电视胸腔镜(single utility port video-assisted thoracic surgery,single utility portVATS)肺叶切除术治疗早期肺癌的临床效果。方法回顾性分析2009年9月至2011年10月解放军总医院胸外科采用单操作孔VATS肺叶切除术治疗162例早期肺癌患者的临床病例资料(单操作孔组),用同期胸腔镜辅助小切口(video-assisted mini-thoracotomy,VAMT)肺叶切除术221例早期肺癌患者做对照(小切口组),比较两组患者的手术时间、术中出血量、淋巴结清扫数、术后下床时间、拔除胸腔引流管时间及术后并发症等。结果两组患者手术过程均顺利,无围手术期死亡。单操作孔组与小切口组患者术中出血量(162.8±75.6)ml vs.(231.4±62.8)ml、术后下床时间(2.2±0.3)d vs.(3.7±0.5)d、拔除胸腔引流管时间(3.5±0.2)d vs.(4.6±0.4)d,差异有统计学意义(P<0.05);单操作孔组与小切口组患者的手术时间(133.7±22.0)min vs.(124.9±25.7)min、淋巴结清扫数(11.7±1.9)枚vs.(12.5±2.7)枚、并发症发生率7.4%vs.8.1%,差异无统计学意义(P>0.05)。结论单操作孔VATS肺叶切除并淋巴结清扫治疗早期肺癌安全、可靠,较VAMT创伤更小、恢复更快。
Objective To investigate the clinical effect of single-operation port video-assisted thoracic surgery (single utility port VATS) lobectomy in the treatment of early stage lung cancer. Methods A retrospective analysis of clinical data of 162 patients with early-stage lung cancer treated with VATS lobectomy with single-operated hole from September 2009 to October 2011 in the Department of Thoracic Surgery, People’s Liberation Army General Hospital was performed. A simultaneous thoracoscope assisted small incision 221 patients with early-stage lung cancer undergoing video-assisted mini-thoracotomy (VAMT) lobectomy were compared (small incision group). The operation time, intraoperative blood loss, lymph node clearance, Chest drainage tube time and postoperative complications. Results The operation of the two groups was smooth and no perioperative death was found. The intraoperative blood loss (162.8 ± 75.6) ml vs. (231.4 ± 62.8) ml and postoperative bed time (2.2 ± 0.3) days vs. (3.7 ± 0.5) days in the single-operation hole group and the small incision group were The drainage time was (3.5 ± 0.2) d vs. (4.6 ± 0.4) d, and the difference was statistically significant (P <0.05). The operation time of single operation hole group and small incision group was (133.7 ± 22.0) min vs. 124.9 ± 25.7) min, the number of lymph node dissection was (11.7 ± 1.9) vs. (12.5 ± 2.7), the complication rate was 7.4% vs.8.1%, the difference was not statistically significant (P> 0.05). Conclusions VATS lobectomy and lymph node dissection in the treatment of early stage lung cancer is safe and reliable. It has less trauma and faster recovery than VAMT.