Guo Hong, Diao Yali, Fan Huangxin, Luo Qingquan
Department of Thoracic Surgery, Affiliated to Hospital of Yangzhou University, Yangzhou 225000, China.
Department of Thoracic Surgery, Affiliated to Hospital of Shanghai Jiao Tong University, Shanghai 200240, China.
Zhongguo Fei Ai Za Zhi. 2018 Aug 20;21(8):578-582. doi: 10.3779/j.issn.1009-3419.2018.08.02.
Thoracoscopic lobectomy combined with mediastinal lymph node dissection has been considered as one of the standard surgical procedures for early lung cancer. After 20 years of development, thoracoscopic lobectomy has reached a consensus on reliability and minimally invasive. At present, thoracoscopic lobectomy has a variety of incisions, which gradually evolve into four holes based on three holes, and two or one hole as the operative approach. The aim of this study was to evaluate the clinical value of four-hole unilateral dissecting lobectomy and mediastinal lymph node dissection in the treatment of non-small cell lung cancer (NSCLC). The aim of this study was to investigate the clinical value of anatomical lobectomy with mediastinal lymphadenectomy under four-hole completely video-assisted thoracoscopic surgery (C-VATS) in the treatment of non-small cell lung cancer.
The patients undergoing lobectomy with mediastinal lymphadenectomy for NSCLC were identified in the Department of Thoracic Surgery, Yangzhou First People's Hospital, Yangzhou University from March 2015 to July 2016. Preoperative clinical diagnosis of peripheral-type early NSCLC. The patients were randomly divided into four-hole monophasic group (experimental group) and three-hole group (control group) according to the number of hospitalization before surgery. According to inclusion and exclusion criteria, the 39 cases assign in experimental group and 34 cases in the control group, including 36 males and 37 females; aged 38 to 84 years. The mean operation time, average blood loss, lymph node dissection group, average drainage, average extubation time and postoperative complications were compared between the two groups for statistical analysis.
The two groups of patients were successfully completed surgery, no death after surgery. Mean bleeding in the two groups, the number of lymph node dissection group, the average postoperative drainage, the average time of extubation, postoperative complications, with no significant difference. The average operation time of the four-hole unidirectional group was shorter than that of the three-hole group. The difference was statistically significant (P<0.05).
CONCLUSIONS: The safety and efficacy of a four-hole one-way operation under VATS are satisfactory. The operation is smooth during operation, which shortens the course of operation and deserves the clinical promotion. .
电视胸腔镜肺叶切除术联合纵隔淋巴结清扫术被认为是早期肺癌的标准手术方式之一。经过20年的发展,电视胸腔镜肺叶切除术在可靠性和微创性方面已达成共识。目前,电视胸腔镜肺叶切除术有多种切口,逐渐由三孔演变为四孔,并以两孔或单孔作为手术入路。本研究旨在评估四孔单向式肺叶切除术联合纵隔淋巴结清扫术治疗非小细胞肺癌(NSCLC)的临床价值。本研究旨在探讨四孔全胸腔镜手术(C-VATS)下解剖性肺叶切除联合纵隔淋巴结清扫术治疗非小细胞肺癌的临床价值。
选取2015年3月至2016年7月在扬州大学附属扬州市第一人民医院胸外科行肺叶切除联合纵隔淋巴结清扫术治疗NSCLC的患者。术前临床诊断为外周型早期NSCLC。根据术前住院天数将患者随机分为四孔单向组(实验组)和三孔组(对照组)。根据纳入和排除标准,实验组39例,对照组34例,其中男性36例,女性37例;年龄38~84岁。比较两组患者的平均手术时间、平均出血量、淋巴结清扫组数、平均引流量、平均拔管时间及术后并发症,并进行统计学分析。
两组患者均顺利完成手术,术后无死亡。两组患者的平均出血量、淋巴结清扫组数、术后平均引流量、平均拔管时间、术后并发症比较,差异无统计学意义。四孔单向组的平均手术时间短于三孔组。差异有统计学意义(P<0.05)。
VATS下四孔单向手术的安全性和疗效满意。手术过程顺利,缩短了手术时间,值得临床推广。