Guo Xinyu, Liu Dajiang, Shao Zhuang, Meng Yongsheng, Huang Bingyang, Song Xiaoyong
Department of Thoracic Surgery, Specialty Medical Center of the People's Liberation Army Strategic Support Force, Beijing, China.
J Thorac Dis. 2025 May 30;17(5):3118-3127. doi: 10.21037/jtd-2024-1930. Epub 2025 May 28.
Lung diseases often require surgical intervention for effective management, and with the evolution of thoracoscopic techniques, minimally invasive options like single-port video-assisted thoracoscopic surgery (VATS) have gained prominence over traditional open surgery due to their reduced invasiveness and improved outcomes. Despite its promising benefits, single-port VATS still encounters challenges that demand further investigation to optimize its clinical application. Therefore, this study aimed to compare the safety, efficacy, and postoperative lung function recovery between single-port and multiport thoracoscopic lung segmentectomy.
Clinical data of a total of 105 patients with lung diseases admitted to our hospital (January 2021 to December 2022) were retrospectively analyzed. Based on different surgical approaches, patients were divided into single-port (single-port thoracoscopic lung segmentectomy, n=82) and the multiport (multiport thoracoscopic lung segmentectomy, n=23) groups. Surgical time, intraoperative blood loss, conversion to open surgery rate, length of hospital stays, hospitalization costs, complication and reoperation rates, Visual Analog Scale (VAS) scores, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC ratio, and carbon monoxide diffusion capacity (DLCO) were compared between the two groups.
There were no significant differences in surgical time, conversion to open surgery rate, and reoperation rates between the two groups (P>0.05). The single-port group exhibited lower intraoperative blood loss than the multiport group (P<0.05). The length of hospital stays, hospitalization costs, short-term and long-term complication rates were lower in the single-port group compared to the multiport group (P<0.05). Preoperative VAS scores did not differ significantly between the groups (P>0.05), but the VAS scores at 1 and 3 days postoperatively were lower in the single-port group than in the multiport group (P<0.05). Preoperative FVC, FEV1, FEV1/FVC ratio, and DLCO did not significantly differ between the groups (P>0.05); however, at 1 and 3 months postoperatively, FVC, FEV1, FEV1/FVC ratio, and DLCO were superior in the single-port group compared to the multiport group (P<0.05).
In comparison with multiport VATS, single-port VATS demonstrates higher efficacy and safety and promotes better postoperative lung function recovery, and reduces postoperative pain, surgical time, incision length, intraoperative bleeding, length of hospital stay, and hospitalization costs.
肺部疾病通常需要手术干预以实现有效管理。随着胸腔镜技术的发展，单孔视频辅助胸腔镜手术（VATS）等微创术式因其侵袭性降低和预后改善，相较于传统开放手术愈发受到关注。尽管单孔VATS具有诸多优势，但仍面临一些挑战，需要进一步研究以优化其临床应用。因此，本研究旨在比较单孔与多孔胸腔镜肺段切除术的安全性、有效性及术后肺功能恢复情况。
回顾性分析我院2021年1月至2022年12月收治的105例肺部疾病患者的临床资料。根据手术方式不同，将患者分为单孔组（单孔胸腔镜肺段切除术，n = 82）和多孔组（多孔胸腔镜肺段切除术，n = 23）。比较两组患者的手术时间、术中出血量、中转开胸率、住院时间、住院费用、并发症及再次手术率、视觉模拟评分（VAS）、用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、FEV1/FVC比值及一氧化碳弥散量（DLCO）。
两组患者的手术时间、中转开胸率及再次手术率差异无统计学意义（P > 0.05）。单孔组术中出血量低于多孔组（P < 0.05）。单孔组的住院时间、住院费用、短期及长期并发症发生率均低于多孔组（P < 0.05）。两组患者术前VAS评分差异无统计学意义（P > 0.05），但单孔组术后1天和3天的VAS评分低于多孔组（P < 0.05）。两组患者术前FVC、FEV1、FEV1/FVC比值及DLCO差异无统计学意义（P > 0.05）；然而，术后1个月和3个月时，单孔组的FVC、FEV1、FEV1/FVC比值及DLCO均优于多孔组（P < 0.05）。
与多孔VATS相比，单孔VATS具有更高的有效性和安全性，能促进更好的术后肺功能恢复，减轻术后疼痛，缩短手术时间、切口长度、术中出血、住院时间及住院费用。
