3D与2D单孔胸腔镜手术治疗非小细胞肺癌的临床效果比较OA
Comparison of clinical efficacy between 3D and 2D single-port video-assisted thoracoscopic surgery for non-small cell lung cancer
目的:对比分析 3D 与 2D 单孔胸腔镜手术(VATS)治疗非小细胞肺癌的临床疗效.方法:回顾性选取 2020 年 5月至 2022 年 7 月采取 VATS 治疗的 231 例非小细胞肺癌患者,根据手术方式分为 3D 组(n=115,行 3D-VATS)与 2D 组(n=116,行 2D-VATS),对比分析两组术中、术后相关指标,手术前后肺功能指标、炎症指标,手术并发症.结果:3D 组手术时间短于 2D 组,出血量少于 2D 组,差异有统计学意义(P＜0.05);两组清扫淋巴结数量、术后引流量、术后住院时间差异均无统计学意义(P＞0.05);术前,两组第一秒用力呼气容积占预计值百分比、用力肺活量占预计值百分比、最大呼气流量差异无统计学意义(P＞0.05);术后 1 个月,3D 组第一秒用力呼气容积占预计值百分比、用力肺活量占预计值百分比高于 2D 组,差异有统计学意义(P＜0.05).术前,两组血清肿瘤坏死因子 α、C 反应蛋白、IL-6 差异无统计学意义(P＞0.05);术后第 3 天,3D 组血清肿瘤坏死因子 α、IL-6 低于 2D 组,差异有统计学意义(P＜0.05).3D 组并发症发生率低于 2D 组,差异有统计学意义(6.09%vs.15.52%,P＜0.05).结论:对于非小细胞肺癌,3D-VATS 与 2D-VATS 的治疗效果均较好,3D-VATS 具有手术时间短、出血少、肺功能恢复效果好、炎症水平低、并发症少的优势.
Objective:To comparatively analyze the clinical efficacy of 3D and 2D single-port video-assisted thoracoscopic sur-gery(VATS)in the treatment of non-small cell lung cancer.Methods:A total of 231 patients with non-small cell lung cancer treated with VATS from May 2020 to Jul.2022 were retrospectively enrolled.According to the surgical method,the patients were divided into the 3D group(n=115,treated with 3D-VATS)and the 2D group(n=116,treated with 2D-VATS).Intraoperative and postoperative re-lated indicators,perioperative pulmonary function indicators,inflammatory indicators and surgical complications were compared be-tween the two groups.Results:The operative time in the 3D group was shorter than that in the 2D group,and the intraoperative blood loss in the 3D group was less than that in the 2D group,with statistically significant differences(P＜0.05).There were no statistically significant differences in the number of dissected lymph nodes,postoperative drainage volume,and postoperative hospital stay between the two groups(P＞0.05).Preoperative forced expiratory volume in the first second as a percentage of predicted value,forced vital ca-pacity as a percentage of predicted value and peak expiratory flow were comparable between the two groups(P＞0.05).One month af-ter surgery,the forced expiratory volume in the first second as a percentage of predicted value and forced vital capacity as a percentage of predicted value of the 3D group were higher than those of the 2D group,with statistically significant differences(P＜0.05).Preopera-tive serum tumor necrosis factor-α,C-reactive protein and IL-6 levels showed no statistical differences between the two groups(P＞0.05).On the 3rd day after operation,the serum tumor necrosis factor-ɑ and IL-6 levels were lower in the 3D group than those in the 2D group,with statistically significant differences(P＜0.05).The complication rate was 6.09%in the 3D group,which was lower than 15.52%in the 2D group(P＜0.05).Conclusions:Both 3D-VATS and 2D-VATS have good therapeutic effects on non-small cell lung cancer.3D-VATS has the advantages of shorter operation time,less intraoperative blood loss,better postoperative pulmonary function recovery,lower postoperative inflammatory level,and fewer complications.
侯博峰;赵亚楠;刘丹;王继云;宋家悦;孙懿
河北中石油中心医院胸外科,河北 廊坊,065000河北中石油中心医院胸外科,河北 廊坊,065000河北中石油中心医院胸外科,河北 廊坊,065000河北中石油中心医院胸外科,河北 廊坊,065000河北中石油中心医院胸外科,河北 廊坊,065000河北中石油中心医院胸外科,河北 廊坊,065000
医药卫生
癌,非小细胞肺胸腔镜检查单孔并发症疗效比较研究
Carcinoma,non-small-cell lungThoracoscopySingle-portComplicationsComparative effectiveness research
《腹腔镜外科杂志》 2026 (7)
496-501,6
廊坊市科学技术研究与发展计划项目(2024013103)
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