前入路隆突下淋巴结清扫在单孔胸腔镜左侧肺癌根治术中的应用

    Application value of anterior subcarinal lymph node dissection in single-port thoracoscopic radical resection of left lung cancer

    • 摘要:
      目的探讨单孔胸腔镜左侧肺癌根治术中经前入路行隆突下淋巴结清扫的可行性及安全性。
      方法回顾性分析行单孔胸腔镜手术治疗的左侧早期非小细胞肺癌病人62例临床资料,按隆突下淋巴结清扫入路的不同分为后入路组34例(传统后入路隆突下淋巴结清扫)和前入路组28例(前入路隆突下淋巴结清扫)。比较2组病人手术时间、手术出血量、纵隔淋巴结清扫数目,术后3 d胸管引流量、胸管留置时间和并发症发生率。
      结果2组病人手术时间、手术出血量、纵隔淋巴结清扫数目及站数、并发症总发生率差异均无统计学意义(P>0.05),前入路组术后3 d胸管引流量、胸管留置时间均少于后入路组(P < 0.05)。
      结论单孔胸腔镜左侧肺癌根治术中经前入路进行隆突下淋巴结清扫可简化操作过程,减少术后胸管引流量及留置时间,是安全可行的方法。

       

      Abstract:
      ObjectiveTo investigate the feasibility and safety of anterior subcarinal lymph node dissection in single-port thoracoscopic radical resection of left lung cancer.
      MethodsThe clinical data of 62 left non-small cell lung cancer patients treated with single-port thoracosopic surgery were retrospectively analyzed.According to different methods for subcarinal lymph node dissection, the patients were divided into the posterior approach group(34 cases treated with traditional posterior approach for subcarinal lymph node dissection) and anterior approach group(28 cases treated with anterior approach for subcarinal lymph node dissection).The data of the operation time, intra-operative blood loss, number of mediastinal lymph node dissection, postoperative 3 d thoracic duct drainage volume, indwelling time of thoracic tube and incidence rate of complications were compared between two groups.
      ResultsThe differences of the operation time, intra-operative blood loss, number of mediastinal lymph nodes dissection and total incidence rate of complications between two groups were not statistically significant(P>0.05).The drainage volume and indwelling time of thoracic duct after 3 d of operation in anterior approach group were shorter than those in posterior approach group(P < 0.05).
      ConclusionsThe anterior subcarinal lymph node dissection in single-port thoracoscopic surgery for radical resection of left lung cancer is a safe and feasible method to simplify the operation process and reduce the postoperative thoracic duct drainage and indwelling time.

       

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