单孔和多孔胸腔镜肺段切除术的疗效对比研究

Comparative Study on the Efficacy of Uniportal and Multiportal Thoracoscopic Pulmonary Segmentectomy

摘要: 目的：比较肺结节患者单孔胸腔镜与多孔胸腔镜下肺段切除术的优缺点，探究单孔胸腔镜辅助下肺段切除术的安全性及可行性。方法：运用回顾性分析研究方法，随机选取106例安徽医科大学第二附属医院胸外科2023年1月至2023年10月接受电视胸腔镜肺段切除术的患者，按手术方式的不同分为观察组(单孔胸腔镜肺段切除术组)和对照组(多孔胸腔镜肺段切除术组)，每组各53例。采用统计学方法比较两组患者一般资料、疼痛评分、围手术期指标、肿瘤复发率和远期生存率。结果：观察组患者手术时间、术中出血量、术后引流量、带管时间、住院时间明显低于对照组(P < 0.05)；两组患者肿瘤复发率和远期生存率无明显差异(P > 0.05)。结论：与多孔胸腔镜肺段切除术相比，行单孔胸腔镜肺段切除术治疗的肺结节患者有相同的疗效和安全性，但术后创伤较小，术后疼痛得到有效缓解，有利于患者康复。

Abstract: Objective: This study aims to compare the pros and cons of uniportal thoracoscopic pulmonary segmentectomy versus multiportal thoracoscopic pulmonary segmentectomy in patients with pulmonary nodules, while also assessing the safety and feasibility of the uniportal approach. Methods: A retrospective analysis was conducted on 106 patients who underwent video-assisted thoracoscopic pulmonary segmentectomy in the Department of Thoracic Surgery at the Second Affiliated Hospital of Anhui Medical University. The patients were divided into two groups: the observation group (uniportal thoracoscopic segmentectomy) and the control group (multiportal thoracoscopic segmentectomy), with 53 patients in each group. Statistical analyses were performed to compare demographic data, pain scores, perioperative outcomes, recurrence rates and long-term survival rates between the two groups. Results: The observation group demonstrated significantly shorter operative times, reduced intraoperative blood loss, lower postoperative drainage volumes, shorter drainage durations, and decreased hospital stays compared to the control group (P < 0.05). Conclusion: Compared with multiportal video-assisted thoracoscopic pulmonary segmentectomy, uniportal video-assisted thoracoscopic pulmonary segmentectomy for patients with pulmonary nodules shows equivalent efficacy and safety, but with less postoperative trauma, effective alleviation of postoperative pain, and better recovery outcomes.