单操作孔肺叶切除术治疗周围型肺癌的临床研究

BACKGROUND AND OBJECTIVE: Video-assisted thoracoscopic surgery (VATS) lobectomy is now generally accepted for patients with lung cancer. The aim of this study is to review the technology of thoracoscopic lobectomy with single utility port in the treatment of peripheral lung cancer. METHODS: We retrospectively analyzed the clinical data of 87 patients with peripheral lung cancer who underwent single utility port complete VATS lobectomy from February 2011 to January 2013 in the First Affiliated Hospital of Soochow University (single utility port group), and compared them with 75 patients with peripheral lung cancer who underwent conventional, 3-port VATS lobectomy in the same period (3-port group). The clinical outcomes including operation time, time to first activity out of bed, postoperative hospital stay, intraoperative blood loss, postoperative drainage volume, chest drainage duration, lymph node dissection number, postoperative complications and degree of chest pain were compared between the two groups. RESULTS: No perioperative death was observed in both groups. There was no statistical difference in operation time (151.03±25.97 min vs 156.27±26.49 min), lymph node dissection number (13.06±1.36 vs 12.61±1.56), intraoperative blood loss (188.62±47.03 mL vs 179.60±28.96 mL) and incidence of serious postoperative complications (18/87 vs 21/75) between the two groups. There were statistical differences in time to first activity out of bed (11.17±8.69 h vs 13.76±7.43 h), postoperative hospital stay (7.18±1.95 d vs 7.92±2.03 d), chest drainage duration (3.85±1.21 d vs 4.43±1.43 d) and total postoperative drainage volume (671.49±178.31 mL vs 736.93±170.39 mL) between the two groups (P < 0.05). The change of vision analogue score (VAS) score between the two groups after operation was also statistically significant (P < 0.01). CONCLUSION: The completely thoracoscopic lobectomy with single utility port is a safe and feasible surgical procedure compared with conventional 3-port VATS lobectomy for selected patients.