CAJ | 학술논문

目的：比较单操作孔电视胸腔镜手术（SP-VATS）与胸腔镜辅助小切口开胸术（VAMT）治疗早期非小细胞肺癌（NSCLC）的围术期临床疗效。方法将2010年10月至2012年10月该科收治的286例早期NSCLC患者分为SP-VATS组（150例）和VAMT组（136例），记录两组患者的手术时间、术中出血量、引流时间、术后总引流量、淋巴结清扫数、术后并发症、术后疼痛程度等。结果两组患者均顺利完成手术，无围术期死亡病例。SP-VATS组与VAMT组的手术时间、淋巴结清扫数和术后并发症比较，差异无统计学意义（P＞0．05）；但SP-VATS组患者术中出血量、术后总引流量、引流管放置天数和术后疼痛（术后第1～3天）评分小于VAMT组，差异有统计学意义（P＜0．05）。两组患者并发症发生率差异无统计学意义（P＞0．05）结论SP-VATS肺叶切除术安全、可靠，较VAMT创伤小，恢复快。SP-VATS肺叶切除术可作为治疗早期NSCLC的推荐手术方式。
목적：비교단조작공전시흉강경수술（SP-VATS）여흉강경보조소절구개흉술（VAMT）치료조기비소세포폐암（NSCLC）적위술기림상료효。방법장2010년10월지2012년10월해과수치적286례조기NSCLC환자분위SP-VATS조（150례）화VAMT조（136례），기록량조환자적수술시간、술중출혈량、인류시간、술후총인류량、림파결청소수、술후병발증、술후동통정도등。결과량조환자균순리완성수술，무위술기사망병례。SP-VATS조여VAMT조적수술시간、림파결청소수화술후병발증비교，차이무통계학의의（P＞0．05）；단SP-VATS조환자술중출혈량、술후총인류량、인류관방치천수화술후동통（술후제1～3천）평분소우VAMT조，차이유통계학의의（P＜0．05）。량조환자병발증발생솔차이무통계학의의（P＞0．05）결론SP-VATS폐협절제술안전、가고，교VAMT창상소，회복쾌。SP-VATS폐협절제술가작위치료조기NSCLC적추천수술방식。
Objective To compare the clinical effects of lobectomy by single utility port video-assisted thoracoscopic surgery (SP-VATS) and video-assisted mini-thoracotomy(VAMT) for treating early-stage non-small cell lung cancer(NSCLC) .Methods 286 patients with early-stage NSCLC in our hospital from October 2010 to October 2012 were randomly divided into the SP-VATS group(n=150) and the VAMT group(n=136) ,and received lobectomy and lymph node dissection by SP-VATS and VAMT re-spectively .The operative time ,intraoperative blood loss ,chest drainage duration ,postoperative total drainage volume ,lymph node dissection number ,postoperative complications and postoperative pain were compared between the two groups .Results The two groups were smoothly performed the operation .There was no perioperative death .The operative time ,lymph node dissection num-ber and postoperative complications showed no statistically significant difference between the two groups (P>0 .05) .However ,intr-aoperative blood loss ,postoperative total drainage volume ,chest drainage duration and postoperative pain scores (postoperative 1 -3 d) in the SP-VATS group were less than those in the VAMT group ,the differences showed statistical significance (P<0 .05) . The incidence of complications in the two groups showed no statistically significant difference (P>0 .05) .Conclusion SP-VATS lo-bectomy for treating NSCLC is safe and reliable with less injury and rapid postoperative recovery compared with VAMT .SP-VATS lobectomy may be as a preferred surgical mode for early-stage NSCLC .