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[单孔与多孔电视辅助胸腔镜手术治疗原发性肺癌]

[Uniportal versus Multiportal Video-assisted Thoracic Surgery for Primary Lung Cancer].

作者信息

Matsuura Natsumi, Igai Hitoshi, Yazawa Tomohiro, Ohsawa Fumi, Yoshikawa Ryouhei, Kamiyoshihara Mitsuhiro

机构信息

Department of Thoracic Surgery, Japanese Red Cross Maebashi Hospital, Maebashi, Japan.

出版信息

Kyobu Geka. 2021 Mar;74(3):167-171.

Abstract

OBJECTIVES

This study aimed to consider the safety and feasibility of uniportal video-assisted thoracic surgery( VATS)[ u-VATS] compared with multiportal VATS( m-VATS).

METHODS

Sixty-two patients underwent anatomical lung resection for primary lung cancer via u-VATS between February 2019 and May 2020 at our institution. We performed propensity score matching of these cases versus anatomical lung resection cases under m-VATS performed from January 2017 to December 2019, and compared the perioperative results.

RESULTS

In the u-VATS group, operation time( 142 minutes vs. 178 minutes, p<0.01) and postoperative drainage days( 1.6 days vs. 2.4 days, p=0.01) were significantly shorter. There were no differences in intraoperative blood loss, vascular damage, conversion rate, number of lymph nodes dissected, postoperative complications, and postoperative hospital stay. The number of pain complaints and the number of analgesics (non-steroidal anti-inflammatory drugs:NSAIDs) prescribed at the first outpatient clinic after discharge were significantly lower in the u-VATS group( 10 vs. 22, p=0.03).

CONCLUSIONS

U-VATS shortened the operation time and postoperative drainage period compared with conventional m-VATS, and significantly reduced the use of analgesics. U-VATS is considered to be safe and less invasive surgical procedure based on the present study.

摘要

目的

本研究旨在探讨单孔电视辅助胸腔镜手术(u-VATS)与多孔电视辅助胸腔镜手术(m-VATS)相比的安全性和可行性。

方法

2019年2月至2020年5月,我院62例原发性肺癌患者接受了u-VATS解剖性肺切除术。我们对这些病例与2017年1月至2019年12月期间接受m-VATS解剖性肺切除术的病例进行倾向评分匹配,并比较围手术期结果。

结果

u-VATS组的手术时间(142分钟对178分钟,p<0.01)和术后引流天数(1.6天对2.4天,p=0.01)明显更短。术中出血量、血管损伤、中转率、清扫淋巴结数量、术后并发症和术后住院时间无差异。u-VATS组出院后首次门诊时的疼痛主诉数量和开具的镇痛药(非甾体抗炎药:NSAIDs)数量明显更低(10对22,p=0.03)。

结论

与传统的m-VATS相比;u-VATS缩短了手术时间和术后引流时间,并显著减少了镇痛药的使用。基于本研究,u-VATS被认为是一种安全且侵入性较小的手术方法。

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