【摘要】：目的：探討單孔胸腔鏡模塊化肺癌根治術(shù)在肺癌外科治療中的安全性、可行性及手術(shù)切除效果。方法：回顧性分析我科自2015年3月至2015年12月間實(shí)施單孔胸腔鏡和三孔胸腔鏡模塊化肺癌根治的肺癌患者資料共334例,其中單孔胸腔鏡手術(shù)(單孔組)225例,三孔胸腔鏡手術(shù)(三孔組)109例。所有患者均按照模塊化肺癌根治的方法進(jìn)行手術(shù),即將解剖性肺葉／肺段切除±系統(tǒng)性淋巴結(jié)清掃劃分為五個(gè)模塊：①下縱隔第8、9組淋巴結(jié)模塊；②隆突下第7組淋巴結(jié)模塊；③右側(cè)上縱隔2R、4R組淋巴結(jié)模塊；④左側(cè)上縱隔4L～6組淋巴結(jié)模塊和⑤解剖性肺葉／肺段切除模塊。根據(jù)左側(cè)和右側(cè)肺部手術(shù)的不同技術(shù)路線依次進(jìn)行各個(gè)模塊的操作完成全部手術(shù)。對(duì)比兩組患者的一般臨床特征、腫瘤特征和手術(shù)相關(guān)資料(包括術(shù)中胸膜粘連情況、手術(shù)時(shí)間、術(shù)中出血量、手術(shù)方式、淋巴結(jié)清掃枚數(shù)、中轉(zhuǎn)開(kāi)胸情況等),比較兩組患者術(shù)后ICU治療時(shí)間、纖支鏡吸痰人數(shù)及人均吸痰次數(shù),分析兩組術(shù)后胸管引流時(shí)間、術(shù)后住院時(shí)間及術(shù)后并發(fā)癥發(fā)生率。根據(jù)患者術(shù)后不同TNM分期,在I期、II期和III期患者中分別對(duì)兩種術(shù)式的上述指標(biāo)再次進(jìn)行對(duì)比分析。結(jié)果：?jiǎn)慰捉M225例患者中共有男性126例,女性99例,三孔組109例中有男性66例,女性43例,兩組患者的一般臨床資料及腫瘤特征均無(wú)差異(P均0.05)。兩組無(wú)圍手術(shù)期死亡病例。單孔組共12例術(shù)中中轉(zhuǎn)增加操作孔或開(kāi)胸手術(shù),三孔組4例中轉(zhuǎn)開(kāi)胸,兩組中轉(zhuǎn)率無(wú)統(tǒng)計(jì)學(xué)差異(P=0.504)。單孔組平均手術(shù)時(shí)間(144.9±16.0)min,較三孔組(135.1±13.9)min更長(zhǎng)(P0.001),術(shù)中出血量(79.9±27.8)ml和三孔組(77.7±22.2)ml相比無(wú)統(tǒng)計(jì)學(xué)差異(P=0.463)；人均清掃淋巴結(jié)枚數(shù)方面單孔組為(17.4±3.0)枚,三孔組為(17.6±2.8)枚,兩組之間無(wú)統(tǒng)計(jì)學(xué)差異(P=0.580)。術(shù)后ICU治療時(shí)間[(24.2±9.6)h vs(25.4+7.9)h]和床邊纖支鏡吸痰率(24.9% vs 27.5%)兩組之間均無(wú)顯著差異(P=0.264,P=0.606),但單孔組吸痰人群中人均吸痰次數(shù)(1.4±0.6次)較三孔組(1.6±0.7次)更少(P=0.046),未發(fā)現(xiàn)兩組術(shù)后并發(fā)癥發(fā)生率有顯著區(qū)別(P均0.05)。單孔組術(shù)后胸管平均置管(4.4±1.3)天,顯著低于三孔組的(5.0±1.3)天(P0.001),術(shù)后住院時(shí)間單孔組亦較三孔組顯著縮短[(9.4±1.4)天vs(10.3±1.6)天,P0.001]。根據(jù)TNM分期在Ⅰ期、Ⅱ期和Ⅲ期患者中再次分別比較兩種術(shù)式的臨床應(yīng)用情況,發(fā)現(xiàn)三個(gè)不同分期患者中,單孔胸腔鏡手術(shù)時(shí)間均較三孔胸腔鏡顯著延長(zhǎng)[Ⅰ期：(140.2±11.6min vs 131.9±11.1)min, P＜0.001;Ⅱ期：(157.0±17.0) min vs (140.0±11.5) min, P=0.001;Ⅲ期：(158.8±21.1) min vs (141.6±19.8) min, P=0.004)],但術(shù)中出血量、手術(shù)方式、淋巴結(jié)清掃枚數(shù)及中轉(zhuǎn)率方面兩種術(shù)式之間均無(wú)顯著差異。在三個(gè)分期患者中,術(shù)后ICU治療時(shí)間、纖支鏡吸痰人數(shù)和術(shù)后并發(fā)癥發(fā)生率在兩種術(shù)式之間亦無(wú)明顯區(qū)別,但Ⅰ期患者術(shù)后纖支鏡吸痰人群的人均吸痰次數(shù)在單孔組(1.3±0.6)較三孔組(1.6±0.7)更少(P=0.045),在Ⅱ期和Ⅲ期患者中,兩種術(shù)式之間并無(wú)顯著區(qū)別(P--0.574,P=0.875)。在三個(gè)不同分期中,單孔術(shù)式術(shù)后胸管引流時(shí)間均較三孔術(shù)式更短[I期：(4.4±1.2)d vs(4.7±1.1)d,P=0.041：Ⅱ期：(4.6±2.0)d vs(5.8±1.6)d,P=0.050；Ⅲ期： (4.4±1.3)d vs(5.4±1.4)d,P=0.010]；Ⅰ期和Ⅲ期患者中,單孔術(shù)式術(shù)后住院時(shí)間亦顯著少于三孔組[Ⅰ期：(9.2±1.0)d vs(9.3±1.3)d,P=0.002;Ⅲ期：(10.0±1.9)d vs(11.6±1.9)d,P=0.004],而Ⅱ期患者中,兩種術(shù)式術(shù)后住院時(shí)間無(wú)顯著差別[Ⅱ期：(10.0±2.2)d vs(10.9±1.5)d,P=0.144]。結(jié)論：?jiǎn)慰仔厍荤R下模塊化肺癌根治術(shù)具有一定的臨床應(yīng)用可行性,其手術(shù)切除效果和三孔胸腔鏡手術(shù)相似,不會(huì)增加患者術(shù)后并發(fā)癥風(fēng)險(xiǎn)且能促進(jìn)其術(shù)后快速康復(fù)。目的：探討單孔胸腔鏡模塊化肺癌根治性切除對(duì)縱隔淋巴結(jié)的清掃效果,評(píng)估該手術(shù)方法在肺癌外科治療中的應(yīng)用價(jià)值。方法：回顧性分析我科自2015年3月至2015年12月間實(shí)施單孔胸腔鏡或三孔胸腔鏡肺癌根治的非小細(xì)胞肺癌患者共311例,其中單孔胸腔鏡手術(shù)(單孔組)208例,三孔胸腔鏡手術(shù)(三孔組)103例。所有患者均按照模塊化肺癌根治的方法行解剖性肺葉/肺段切除+系統(tǒng)性淋巴結(jié)清掃。對(duì)比兩組患者的一般臨床特征、腫瘤特征和手術(shù)相關(guān)資料(包括手術(shù)時(shí)間、術(shù)中出血量、手術(shù)方式、術(shù)后胸管置管時(shí)間、術(shù)后住院時(shí)間及并發(fā)癥發(fā)生率等),比較兩組患者的淋巴結(jié)清掃總組數(shù)和總枚數(shù)、N2站淋巴結(jié)清掃的組數(shù)和枚數(shù)等,并分別對(duì)左、右兩側(cè)各N2站淋巴結(jié)的清掃情況進(jìn)行統(tǒng)計(jì)和對(duì)比。分別在I期、II期和IIIa期患者中,再次比較兩種術(shù)式對(duì)縱隔淋巴結(jié)清掃的效果。結(jié)果：?jiǎn)慰捉M共有男性110例,女性98例,三孔組有男性61例,女性42例,兩組患者的一般臨床資料及腫瘤特征均無(wú)差異(P均0.05)。兩組均無(wú)圍手術(shù)期死亡病例,在手術(shù)方式上無(wú)差異,單孔組手術(shù)時(shí)間為(144.8±15.3)min,顯著長(zhǎng)于三孔組[(135.1±13.9)min,P0.001],但術(shù)中出血量?jī)山M無(wú)顯著差異。在淋巴結(jié)清掃方面,單孔組人均清掃胸腔內(nèi)淋巴結(jié)(7.3±1.0)組,共(17.5±3.0)枚,三孔組人均清掃淋巴結(jié)(7.2±1.0)組,共(17.7±2.7)枚,在清掃的組數(shù)和枚數(shù)上兩種術(shù)式之間無(wú)統(tǒng)計(jì)學(xué)差異(P=0.208,P=0.596)。進(jìn)一步對(duì)縱隔N2站淋巴結(jié)進(jìn)行分析,單孔組人均清掃N2站淋巴結(jié)(4.3±0.7)組,共(8.6±1.1)枚,三孔組人均清掃N2站淋巴結(jié)(4.3±0.6)組,共(8.5±1.1)枚,兩種術(shù)式對(duì)縱隔淋巴結(jié)的清掃效果同樣相似(P--0.850,P=0.587)。在對(duì)左、右兩側(cè)各N2站淋巴結(jié)的清掃率及清掃枚數(shù)上,兩種術(shù)式間相比無(wú)統(tǒng)計(jì)學(xué)差異(P均0.05)。在Ⅰ期、Ⅱ期和Ⅲa期患者中,單孔胸腔鏡和三孔胸腔鏡手術(shù)在清掃的淋巴結(jié)組數(shù)、人均清掃枚數(shù)及對(duì)N2站淋巴結(jié)清掃的組數(shù)和人均清掃枚數(shù)上亦均無(wú)顯著差異(P均0.05)。單孔組術(shù)后胸管引流時(shí)間和住院時(shí)間分別為(4.4±1.3)天和(9.2±0.9)天,均較三孔組[(5.0±1.3)天, (9.8±2.0)天]更短且有顯著統(tǒng)計(jì)學(xué)差異(P均0.001),未發(fā)現(xiàn)兩組術(shù)后并發(fā)癥發(fā)生率存在顯著差異(P均0.05)。結(jié)論：?jiǎn)慰仔厍荤R下模塊化肺癌根治術(shù)能夠達(dá)到和傳統(tǒng)三孔胸腔鏡手術(shù)相同的淋巴結(jié)清掃效果,其在縱隔淋巴結(jié)清掃方面亦不遜色于三孔胸腔鏡手術(shù),在肺癌根治性外科治療中具有一定的臨床應(yīng)用價(jià)值。目的：探索使用雙16F胸管U型置管引流在單孔胸腔鏡肺癌根治術(shù)后胸腔引流中應(yīng)用的可行性、安全性及引流效果。方法：分析我科自2014年9月至2015年2月間實(shí)施單孔胸腔鏡肺癌根治的非小細(xì)胞肺癌患者共88例,30F胸管引流組(粗胸管組)術(shù)后經(jīng)切口留置1根30F胸管,16F胸管引流組(細(xì)胸管組)術(shù)后經(jīng)切口留置2根16F胸管,并使其在胸腔內(nèi)呈U型擺放(側(cè)位觀察)。對(duì)比兩組患者的一般臨床特征、腫瘤特征和手術(shù)資料和術(shù)后并發(fā)癥情況,比較兩組患者術(shù)后人均胸管引流總量、引流天數(shù)及術(shù)后住院天,以視覺(jué)模擬評(píng)分(visual analogue scale, VAS)法評(píng)估兩組患者術(shù)后第3、7天時(shí)疼痛的最小(VASmin-d3、d7)及最大(VASmin-d3、d7)值,對(duì)比兩組患者術(shù)后三月切口麻木發(fā)生率。結(jié)果：兩組患者的一般臨床資料及腫瘤特征均無(wú)差異(P均0.05)。兩組無(wú)圍手術(shù)期死亡病例,在手術(shù)方式、術(shù)中出血量及淋巴結(jié)清掃枚數(shù)上亦無(wú)差異(P均0.05),細(xì)胸管組胸管引流時(shí)間為(5.2±2.1)d,而粗胸管組術(shù)后平均胸管留置時(shí)間為(6.2±2.4)d,兩組相比具有統(tǒng)計(jì)學(xué)意義(P=0.044),但兩組在術(shù)后總引流量上并無(wú)差異[(1172.6±348.3)ml vs(1245.7±422.6)ml,P=0.138]；粗管組術(shù)后住院時(shí)間為(12.8±2.4)d,較細(xì)管組的(11.7±2.6)d更長(zhǎng)(P=0.043)。細(xì)管組術(shù)后切口滲液率(2.2%)較粗管組(16.7%)顯著降低(P=0.025),在其他并發(fā)癥上兩組之間并無(wú)明顯統(tǒng)計(jì)學(xué)差異。細(xì)管組術(shù)后第3天和第7天的VASmin和粗管組相比無(wú)顯著差異(P均0.05),但細(xì)管組術(shù)后第3天和第7天的VASmax(3.77±0.75,2.02±039)均顯著低于粗管組(4.14±0.75,2.21±0.41),差異具有統(tǒng)計(jì)學(xué)意義(P=0.022,P=0.046)。術(shù)后三月細(xì)管組切口麻木發(fā)生率為19.6%,和粗管組(40.5%)相比具有顯著統(tǒng)計(jì)學(xué)意義(P=0.032)。結(jié)論：雙16F胸管U型置管能夠安全有效地用于單孔胸腔鏡肺癌根治術(shù)后胸腔引流管理,能夠縮短患者術(shù)后胸腔引流天數(shù)及術(shù)后住院天數(shù),并能減輕術(shù)后疼痛及術(shù)后切口麻木不適感,有助于患者術(shù)后快速康復(fù)。目的：本研究擬評(píng)估單孔胸腔鏡模塊化肺癌根治術(shù)對(duì)患者術(shù)后疼痛及短期生活質(zhì)量的影響,進(jìn)一步探討其臨床應(yīng)用的價(jià)值。方法：選取2015年3月至2015年11月在我科行單孔胸腔鏡(單孔組)模塊化肺癌根治或三孔胸腔鏡(三孔組)肺癌根治術(shù)的非小細(xì)胞肺癌患者272例,其中單孔組176例,三孔組96例。對(duì)比兩組的臨床及手術(shù)資料,以視覺(jué)模擬評(píng)分(visual analogue scale, VAS)法評(píng)估兩組患者術(shù)后第3、7天時(shí)疼痛的最小(VASmin-d3、d7)及最大(VASmax-d3、 d7)值,肺癌治療功能性量表(Functional Assessment of Cancer Treatment-Lung， FACT-L)中文版v4.0評(píng)測(cè)兩組患者術(shù)前及術(shù)后三月的生活質(zhì)量,對(duì)比兩組術(shù)后三月切口麻木發(fā)生率及患者對(duì)切口外觀的滿意度。結(jié)果：兩組患者的一般臨床資料無(wú)差異,均無(wú)圍手術(shù)期死亡病例,單孔組手術(shù)時(shí)間(144.3±15.50)min較三孔組(135.1±14.3)min更長(zhǎng)(P0.001),但術(shù)后胸管置管時(shí)間和術(shù)后住院時(shí)間在單孔組[(4.4±1.2)d,(9.5±1.3)d]均明顯短于三孔組[(5.0±1.4)d, (10.2±1.6)d](P均0.001)；兩組患者術(shù)后VASmin-d3無(wú)顯著差異,但單孔組VASmin-d7及VASmax-d3、d7(1.41±0.26,3.74±0.54,2.39±0.51)均顯著低于三孔組(1.54±0.28,3.94±0.51,2.64±0.60)(P=0.003,P=0.003,P0.001)。FACT-L評(píng)分顯示術(shù)后三月單孔組患者功能狀態(tài)、情感狀態(tài)和整體生活質(zhì)量得分(21.1±2.1,20.1±1.7,108.6±4.4)均顯著高于三孔組患者(20.2±1.9,19.3±1.7,106.8±4.2)(P=0.005,P=0.004,P=0.008),而生理狀態(tài)、社會(huì)/家庭狀態(tài)及肺癌相關(guān)癥狀評(píng)分兩組并無(wú)顯著差異。和三孔組相比,單孔組術(shù)后三月切口麻木發(fā)生率(25.6% vs 40.6%)更低(P=0.010),患者對(duì)切口的滿意度更高(77.8% vs 64.6%,P=0.018)。結(jié)論：和三孔胸腔鏡相比,單孔胸腔鏡模塊化肺癌根治術(shù)能夠減輕患者術(shù)后疼痛,改善術(shù)后短期生活質(zhì)量,在肺癌的外科治療中有一定臨床應(yīng)用價(jià)值。
[Abstract]:Objective: To evaluate the safety, feasibility and surgical outcome of single-hole thoracoscopic modular lung cancer radical surgery. Methods: A retrospective analysis of 334 lung cancer patients who underwent single-hole thoracoscopic and three-hole thoracoscopic modular lung cancer radical surgery from March 2015 to December 2015 was performed. All patients underwent modular lung cancer radical resection, i.e. dissected lobectomy / segmentectomy + systemic lymph node dissection, which was divided into five modules: (1) lower mediastinum lymph node module 8, 9; subcarina lymph node module 7; and (3) upper right lymph node module 3. Mediastinal 2R, 4R lymph node module; left upper mediastinum 4L ~ 6 lymph node module and_anatomical pulmonary lobectomy / segmentectomy module. According to the different technical routes of left and right lung surgery, each module was operated in turn to complete all the operations. Including intraoperative pleural adhesion, operation time, intraoperative bleeding, operation methods, lymph node dissection, conversion to thoracotomy, etc., the ICU treatment time, the number of fiberoptic bronchoscope sputum aspiration and the number of times per person were compared between the two groups, and the postoperative thoracic drainage time, postoperative hospitalization time and postoperative complications were analyzed. Results: There were 126 males and 99 females in 225 patients with single orifice group, 66 males and 43 females in 109 patients with three orifices group. There were no differences in general clinical data and tumor characteristics between the two groups (P 0.05). There was no perioperative mortality. There were 12 cases in the single-hole group and 4 cases in the three-hole group who were converted to open thoracotomy. There was no significant difference in the conversion rate between the two groups (P = 0.504). The average operation time in the single-hole group was (144.9 (+ 16.0) minutes, which was longer than that in the three-hole group (135.1 (+ 13.9) minutes (P 0.001). The intraoperative bleeding volume was (79.9 (+ 27.8) ml) and that in the three-hole group (77.7 (+ 22.2) ml). There was no significant difference between the two groups (P = 0.463); there was no significant difference in the number of lymph nodes per capita between the single-hole group (17.4 + 3.0) and the three-hole group (17.6 + 2.8) (P = 0.580). However, the average number of suctions per person in the single-hole group (1.4 + 0.6 times) was less than that in the three-hole group (1.6 + 0.7 times) (P = 0.046). No significant difference was found in the incidence of postoperative complications between the two groups (P = 0.05). The average postoperative chest tube placement time in the single-hole group (4.4 + 1.3 days) was significantly lower than that in the three-hole group (5.0 + 1.3 days) (P 0.001). According to the clinical application of TNM staging in stage I, stage II and stage III patients, it was found that the operation time of single-hole thoracoscopy was significantly longer than that of three-hole thoracoscopy in three different stages [stage I: (140.2 65 Phase II: 157.0 + 17.0 min vs (140.0 + 11.5) min, P = 0.001; Phase III: 158.8 + 21.1 min vs (141.6 + 19.8) min, P = 0.004), but there was no significant difference in the amount of bleeding, the number of lymph node dissections, and the rate of conversion between the two methods. There was no significant difference in the number of sputum aspirations and the incidence of postoperative complications between the two procedures, but the number of sputum aspirations per person in the single-hole group (1.3.6) was less than that in the three-hole group (1.6.7) (P = 0.045), and there was no significant difference between the two procedures in the second and third stages (P - 0.574, P = 0.875). In the middle, the time of thorthorthorthorthorthorthorthorthorthorthorthorthorthorthorthorthorthorthorthordrainwas shortethan that of three-hole operation [I stage: (4.4 1.2) days vs (4.4 ((4.4 1.2) days vs (4.7 (1.7 1.1 1) d, P = 0.041: 2 (P = 0.041: 0.041: I I stage: (4.6 (5.6 2.0) D vs (5.8 (5.8 1 1 1.8 1.6) 6) days (5 (5.8 0) D vs (9.3 + 1.3) d, P = 0.002; stage III: (10.0 + 1.9) D vs (11.6 + 1.9) d, P = 0.004). There was no significant difference in postoperative hospital stay between the two methods in stage II patients [stage II: (10.0 + 2.2) D vs (10.9 + 1.5) d, P = 0.144]. Objective: To investigate the effect of single-hole modular thoracoscopic radical resection of lung cancer on mediastinal lymph node dissection and evaluate the value of this method in the surgical treatment of lung cancer. A total of 311 patients with non-small cell lung cancer who underwent single-hole thoracoscopic or three-hole thoracoscopic radical resection of lung cancer were enrolled in this study. 208 patients underwent single-hole thoracoscopic surgery (single-hole group) and 103 underwent three-hole thoracoscopic surgery (three-hole group). The total number of lymph node dissection, the number of N2 lymph node dissection and the number of lymph node dissection were compared between the two groups. Results: There were 110 males, 98 females, 61 males and 42 females in the single foramen group and the three foramen group. The general clinical data and tumor characteristics of the two groups were compared. There was no significant difference between the two groups (P 0.05). There were no perioperative deaths and no significant difference in operative methods between the two groups. The operation time in the single-hole group was (144.8 (15.3) minutes, significantly longer than that in the three-hole group [(135.1 (13.9) minutes, P 0.001], but there was no significant difference in the amount of intraoperative bleeding between the two groups. There was no significant difference in the number and number of lymph node dissection between the two groups (P = 0.208, P = 0.596). Further analysis of mediastinal N2 lymph nodes, single-hole group (4.3 + 0.7) and three-hole group (8.6 + 1.1) were performed. There was no significant difference in the clearance rate and number of lymph nodes in the left and right N2 stations between the two methods (all P 0.05). In the patients of stage I, stage II and stage III, single-hole thoracoscopy and three-hole thoracoscopy had the same effect on mediastinal lymph nodes (P--0.850, P = 0.587). There was no significant difference in the number of lymph nodes dissected, the number of lymph nodes dissected per capita, the number of lymph nodes dissected at N2 station, and the number of lymph nodes dissected per capita (P There was no significant difference in the incidence of postoperative complications between the two groups (P 0.001). Conclusion: Single-hole thoracoscopic modular lung cancer radical resection can achieve the same effect of lymph node dissection as traditional three-hole thoracoscopic surgery, and it is not inferior to three-hole thoracoscopic surgery in mediastinal lymph node dissection. Objective: To explore the feasibility, safety and efficacy of double 16F thoracoscopic U-tube drainage in the treatment of non-small cell lung cancer after single-hole thoracoscopic lung cancer radical surgery. A total of 88 patients with cancer were enrolled. One 30F thoracic tube was retained through incision in the 30F thoracic drainage group (thick thoracic tube group) and two 16F thoracic tubes were retained through incision in the 16F thoracic tube drainage group (thin thoracic tube group). The general clinical features, tumor characteristics, surgical data and postoperative complications were compared between the two groups. The total amount of thoracic drainage, drainage days and hospitalization days per patient in both groups were assessed by visual analogue scale (VAS) to evaluate the minimal pain (VASmin-d3, d7) and maximal pain (VASmin-d3, d7) on the 3rd and 7th day after surgery. The incidence of incision numbness was compared between the two groups at 3 months after surgery. There was no difference between the two groups in terms of perioperative mortality, bleeding volume and number of lymph node dissection (P There was no significant difference in total drainage between the two groups (P = 0.044), but there was no significant difference in postoperative drainage between the two groups [(1172.6 + 348.3) ml vs (1245.7 + 422.6) ml, P = 0.138]; the hospitalization time in the tubule group was (12.8 + 2.4) d, longer than that in the tubule group (11.7 + 2.6) D (P = 0.043). The incision exudation rate in the tubule group (2.2%) was significantly lower than that in the tubule group (16.7%) and other complications (P = 0.025). There was no significant difference between the two groups. There was no significant difference in VASmin between the tubule group and the tubule group on the 3rd and 7th day after operation (P 0.05), but the VASmax (3.77.75, 2.02.039) in the tubule group was significantly lower than that in the tubule group on the 3rd and 7th day after operation (4.14.75, 2.21.41), the difference was statistically significant (P = 0.022, P = 0.046). The incidence of incision numbness in the tube group was 19.6%, which was significantly higher than that in the thick tube group (40.5%) (P = 0.032). Conclusion: Double 16F U-tube placement can be safely and effectively used for thoracic drainage management after single-hole thoracoscopic lung cancer radical surgery, which can shorten the days of thoracic drainage and hospitalization, and relieve postoperative pain and pain. Objective: To evaluate the effect of single-hole thoracoscopic modular lung cancer radical resection on postoperative pain and short-term quality of life, and to further explore its clinical value. Two hundred and seventy-two patients with non-small cell lung cancer who underwent modular lung cancer radical resection or three-hole thoracoscopy (three-hole group) were enrolled in this study. (VASmax-d3, d7) value and Chinese version of Functional Assessment of Cancer Treatment-Lung (FACT-L) v4.0 were used to evaluate the quality of life of the two groups before and after surgery in March. The incision numbness rate and the patients'satisfaction with the appearance of the incision were compared between the two groups. There was no perioperative mortality. The operation time of single-hole group was longer than that of three-hole group (P However, VASmin-d7 and VASmax-d3, D7 (1.41+0.26, 3.74+0.54, 2.39+0.51) were significantly lower in the single-hole group than those in the three-hole group (1.54+0.28, 3.94+0.51, 2.64+0.60) (P = 0.003, P = 0.003, P = 0.001). FACT-L scores showed functional status, emotional status and overall quality of life (21.1+2.1, 20.1 + 1.7, 108.4) in the single-hole group three months after surgery. It was significantly higher than that of the three-hole group (20.2 (+ 1.9), 19.3 (+ 1.7), 106.8 (+ 4.2)) (P = 0.005, P = 0.004, P = 0.008), and the physiological status, social / family status.
【學(xué)位授予單位】：華中科技大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R734.2

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10 羅坤;傳統(tǒng)開(kāi)胸、胸腔鏡輔助、完全胸腔鏡肺葉切除術(shù)臨床研究[D];鄭州大學(xué);2016年

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