天津医药

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杂交式单操作孔胸腔镜肺叶切除术治疗早期肺癌的临床研究

王代波1,张逊2,王冬滨3,韩洪利2,徐医军2   

  1. 1. 天津市胸科医院胸外科
    2. 天津市胸科医院外科
    3. 天津市胸科医院
  • 收稿日期:2012-10-16 修回日期:2013-01-21 出版日期:2013-06-15 发布日期:2013-06-15
  • 通讯作者: 王代波

Study on Hybrid Single Utility Port Video-assisted Thoracoscopic Surgery Lobectomy for Patients with Early-stage Lung Cancer

ZHANGXUN 2,Dong-Bin WANG3,HANHONGLI 2,XUJUNYI 2   

  • Received:2012-10-16 Revised:2013-01-21 Published:2013-06-15 Online:2013-06-15

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摘要： 摘要 目的  探讨杂交式单操作孔胸腔镜肺叶切除术治疗早期肺癌的临床效果。方法  将170例早期非小细胞肺癌手术患者，分为实验组和对照组，实验组为杂交式单操作孔胸腔镜组（95例），对照组为单纯小切口组（75例），比较两组患者围手术期的临床及免疫学指标。结果  实验组在切口长度(4.68±0.24)cm vs.(10.14±1.54)cm、术中出血量(173.16±31.56)ml vs.(205.93±39.35)ml、术后1天疼痛评分 (5.00±1.06) vs. (6.11±1.23)、术后住院天数（9.84±0.92）d vs.（12.07±1.46）d等指标均低于对照组（均P ﹤0.05）。实验组与对照组患者手术时间（140.40±28.25）min vs.（134.53±31.11）min、淋巴结清扫数目（11.43±1.74）枚vs.（11.12±1.55）枚、并发症发生率13.7％ vs.24％,差异无统计学意义（均P > 0.05）。实验组术后1天及术后6天C反应蛋白浓度明显低于对照组（P ﹤0.05）；实验组IgG、IgA、IgM浓度在术后1天及术后6天均高于对照组（均P﹤0.05）。结论   杂交式单操作孔胸腔镜肺叶切除术治疗早期肺癌安全、有效，较单纯小切口肺叶切除术创伤更小,免疫功能恢复更快。

关键词: 单操作孔, 电视胸腔镜, 肺叶切除术, 肺癌, C反应蛋白质, 免疫功能

Abstract: Abstract    Objective   To explore the clinical outcomes of hybrid single utility port video-assisted thoracoscopic surgery (VATS) lobectomy for patients with early-stage lung cancer. Methods    From December 2010 to June 2012, 170 surgery patients with early-stage lung cancer were collected and divided into the experimental group and the control group, the experimental group was undergone hybrid single utility port VATS lobectomy (95cases) and the control group was undergone simplemini-incision lobectomy (75cases). The perioperative indicators and the serum levels of humoral immunity were compared between the two groups. Results     There were statistical differences in incision length (4.68±0.24) cm vs. (10.14±1.54) cm, intraoperative blood lose (173.16±31.56) ml vs. (205.93±39.35) ml, numeric pain intensity scale (5.00±1.06) vs. (6.11±1.23), postoperative inpatient days (9.84±0.92) d vs. (12.07±1.46) d between the two groups (P﹤0.05). There were no statistical differences in operation time (140.40±28.25) min vs. (134.53±31.11) min, lymph node dissection number (11.43±1.74) vs. (11.12±1.55), and incidence of serious postoperative complications (13.7％ vs. 24％) between the two groups. The serum levels of C-reactive protein was significantly lower at 1day, 6 day after operation in the experimental group than those of the control group (P﹤0.05). There were statistical differences in the humoral immunity factors，include IgG, IgA, IgM, at 1day, 6 day after operation between the two groups（P﹤0.05）. Conclusions     Hybrid single utility port VATS Lobectomy is safe and reliable for patients with early-stage lung cancer, which is less injury and better immunity recovery than simplemini-incision lobectomy.

Key words: Single utility port, Video-assisted thoracic surgery, Lobectomy, Lung cancer, C-reactive protein, Immunologic function.