Liu Zhengcheng, Yang Rusong, Shao Feng
Department of Thoracic Surgery, Nanjing Chest Hospital Affiliated to Southeast University School of Medicine, Nanjing, People's Republic of China.
Thorac Cardiovasc Surg. 2019 Mar;67(2):142-146. doi: 10.1055/s-0038-1666835. Epub 2018 Jul 9.
To investigate whether the single-port (SP) technique had more favorable postoperative outcomes than had the two-port (TP) technique.
One hundred sixty-six single-port video-assisted thoracoscopic surgery (SP-VATS) lobectomy and 162 two-port video-assisted thoracoscopic surgery (TP-VATS) lobectomy had been successfully completed between August 2015 and September 2016. A single incision of ∼3 cm was made in an intercostal space along the anterior axillary line. Perioperative outcomes and the safety between SP-VATS and TP-VATS lobectomy for NSCLC was compared.
In the SP-VATS group, incision size was kept to a minimum, with a median of 3 cm; mediastinal lymph node dissection was performed in all patients with malignancy. Overall, median operative time was 89 minutes, and median chest tube duration was 3.1 days. The VAS on postoperative days 3, 7, and 14 was less in the SP-VATS group than that in the TP-VATS group. The VAS on days 1, 30, 60, 90, 180, and 360 did not differ significantly between the two groups. The number of days of use of analgesic agents after surgery was less in the SP-VATS group. The pathological symptoms of wound pain were significantly less in the SP-VATS group.
Compared with the multiport approach, SP VATS lobectomy might reduce postoperative pain and lead to faster recovery.
探讨单孔(SP)技术的术后效果是否优于两孔(TP)技术。
2015年8月至2016年9月期间,成功完成了166例单孔电视辅助胸腔镜手术(SP-VATS)肺叶切除术和162例两孔电视辅助胸腔镜手术(TP-VATS)肺叶切除术。沿腋前线在肋间做一个约3cm的单一切口。比较SP-VATS和TP-VATS肺叶切除术治疗非小细胞肺癌(NSCLC)的围手术期结果和安全性。
在SP-VATS组中,切口大小保持最小,中位数为3cm;所有恶性肿瘤患者均进行了纵隔淋巴结清扫。总体而言,中位手术时间为89分钟,中位胸管留置时间为3.1天。SP-VATS组术后第3天、第7天和第14天的视觉模拟评分(VAS)低于TP-VATS组。两组术后第1天、第30天、第60天、第90天、第180天和第360天的VAS无显著差异。SP-VATS组术后使用镇痛剂的天数较少。SP-VATS组伤口疼痛的病理症状明显较少。
与多端口方法相比,SP-VATS肺叶切除术可能减轻术后疼痛并加快恢复。