*Division of Thoracic Surgery, Department of Surgery, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan †Division of Thoracic Surgery, Department of Surgery, Changhua Christian Hospital and Institute of Medicine, Chung Shan Medical University, Chung, Taichung, Taiwan ‡Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan §Division of Thoracic Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Ann Surg. 2015 Apr;261(4):793-9. doi: 10.1097/SLA.0000000000000712.
To compare the perioperative outcomes of single-incision and multiple-incision thoracoscopic lobectomy and segmentectomy.
Reports of single-incision thoracoscopic lobectomy and segmentectomy for lung cancer are limited, and a comparison between single-incision and multiple-incision thoracoscopic lobectomy or segmentectomy for lung cancer has not been previously reported.
From January 2005 to June 2013, a total of 233 patients with lung cancer underwent thoracoscopic lobectomy or segmentectomy via a single-incision or multiple-incision technique. A propensity-matched analysis, incorporating preoperative variables, was used to compare the short-term outcomes between single-incision and multiple-incision thoracoscopic lobectomy and segmentectomy.
Overall, 50 patients underwent single-incision thoracoscopic pulmonary resections, including 35 lobectomies and 15 segmentectomies, and 183 patients underwent multiple-incision thoracoscopic lobectomy or segmentectomy between January 2005 and December 2011. Propensity matching produced 46 patients in each group. The length of hospital stay and the complication rate were not significantly different between the 2 groups. Single-incision thoracoscopic lobectomy and segmentectomy were associated with shorter operative time (P = 0.029), more numbers of lymph nodes (P = 0.032), and less intraoperative blood loss (P = 0.017) than with the multiple-incision approach. No in-hospital mortality occurred in either group.
Single-incision thoracoscopic lobectomy and segmentectomy are feasible, and perioperative outcomes are comparable with those of the multiple-incision approach.
比较单切口和多切口胸腔镜肺叶切除术和肺段切除术的围手术期结果。
单切口胸腔镜肺叶切除术和肺段切除术治疗肺癌的报道有限，且此前尚未报道过肺癌的单切口和多切口胸腔镜肺叶切除术或肺段切除术之间的比较。
2005 年 1 月至 2013 年 6 月，共有 233 例肺癌患者接受了单切口或多切口技术的胸腔镜肺叶切除术或肺段切除术。采用倾向评分匹配分析，结合术前变量，比较单切口和多切口胸腔镜肺叶切除术和肺段切除术的短期结果。
总体而言，50 例患者接受了单切口胸腔镜肺切除术，包括 35 例肺叶切除术和 15 例肺段切除术，183 例患者于 2005 年 1 月至 2011 年 12 月接受了多切口胸腔镜肺叶切除术或肺段切除术。倾向评分匹配后，每组各有 46 例患者。两组患者的住院时间和并发症发生率无显著差异。单切口胸腔镜肺叶切除术和肺段切除术的手术时间更短（P = 0.029），淋巴结清扫数量更多（P = 0.032），术中出血量更少（P = 0.017）。两组均无院内死亡。
单切口胸腔镜肺叶切除术和肺段切除术是可行的，围手术期结果与多切口方法相当。
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