一项前瞻性比较研究,探讨单孔与三孔电视辅助胸腔镜手术对肺癌患者短期生活质量的影响
[A prospective comparative study examing the impact of uniportal and three portal video-assisted thoracic surgery on short-term quality of life in lung cancer].
作者信息
Xu G W, Xiong R, Wu H R, Li C W, Xu S B, Xie M R
机构信息
Department of Thoracic Surgery, the First Affiliated Hospital of University of Science and Technology of China, Hefei 230001, China.
出版信息
Zhonghua Wai Ke Za Zhi. 2018 Jun 1;56(6):452-457. doi: 10.3760/cma.j.issn.0529-5815.2018.06.013.
To evaluate the effect of the postoperative short-term quality of life between uniportal and three portal video-assisted thoracic surgery for radical lung cancer resection. The perioperative data and short-term quality of life of 120 patients received uniportal and three portal video-assisted thoracic surgery for radical lung cancer resection were analyzed from September to November 2017 at Department of Thoracic Surgery, the First Affiliated Hospital of University of Science and Technology of China. There were 64 male and 56 female patients aging of (62±10) years (ranging from 28 to 82 years). There were 60 cases received uniportal (uniportal group) and 60 cases received three portal video-assisted thoracic surgery (three-portal group). Quality of life by measurement of functional and symptom scales was assessed before surgery at baseline, and 1, 2, 4, and 8 weeks after the operation. The test, χ(2) test, Fisher exact test and Wilcoxon rank-sum test were used to compare the date between the 2 groups. Repeated measurement variance was used for comparison of the quality of life at different time points. There were no statistically significant differences in the clinicopathological features of the two groups (>0.05). Intraoperative bleeding volume ((92±85) ml . (131±91) ml, =2.387, =0.019), postoperative catheter time ((4.4±3.1) days . (6.0±3.9) days, =2.401, =0.018), and postoperative hospitalization time ((6.2±4.0) days . (8.3±4.6) days, =2.626, =0.010) in the patients with uniportal group were less than that in three-portal group. Preoperative functional areas, symptom areas and overall health scores were similar in the two group. The functional areas such as physical function, role function, emotional function and social function and overall health status of uniportal group were significantly higher than those of three-portal group in postoperative time, while the fatigue and pain of uniportal group were significantly lower than that of three-portal group. Uniportal video-assisted thoracic surgery can achieve the same safety and radical of three-portal video-assisted thoracic surgery. It has advantages in intraoperative bleeding volume, postoperative time after operation, hospitalization time and postoperative life quality.
评估单孔与三孔电视辅助胸腔镜手术根治性肺癌切除术后短期生活质量的效果。分析2017年9月至11月在中国科学技术大学附属第一医院胸外科接受单孔与三孔电视辅助胸腔镜手术根治性肺癌切除的120例患者的围手术期数据和短期生活质量。其中男性64例,女性56例,年龄(62±10)岁(范围28至82岁)。单孔组60例,三孔电视辅助胸腔镜手术组(三孔组)60例。在术前基线、术后1周、2周、4周和8周通过测量功能和症状量表评估生活质量。采用t检验、χ²检验、Fisher确切概率法和Wilcoxon秩和检验比较两组数据。采用重复测量方差分析比较不同时间点的生活质量。两组患者的临床病理特征无统计学差异(P>0.05)。单孔组患者术中出血量((92±85)ml比(131±91)ml,t=2.387,P=0.019)、术后置管时间((4.4±3.1)天比(6.0±3.9)天,t=2.401,P=0.018)和术后住院时间((6.2±4.0)天比(8.3±4.6)天,t=2.626,P=0.010)均少于三孔组。两组术前功能领域、症状领域和总体健康评分相似。术后各时间点单孔组的身体功能、角色功能、情感功能和社会功能等功能领域及总体健康状况均显著高于三孔组,而单孔组的疲劳和疼痛程度显著低于三孔组。单孔电视辅助胸腔镜手术可达到与三孔电视辅助胸腔镜手术相同的安全性和根治性。在术中出血量、术后恢复时间、住院时间和术后生活质量方面具有优势。