Effect of single-port thoracoscopic lobectomy in the treatment of peripheral lung cancer with moderate-to-severe reduction of lung function

PENG Hai-jun; LI Yi-shuai; ZHANG Lei; ZHOU Yu; DUAN Xiao-liang

doi:10.11659/jjssx.09E022132

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Effect of single-port thoracoscopic lobectomy in the treatment of peripheral lung cancer with moderate-to-severe reduction of lung function

Clinical Research | 更新时间：2023-05-26

- Effect of single-port thoracoscopic lobectomy in the treatment of peripheral lung cancer with moderate-to-severe reduction of lung function
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 32, Issue 5, Pages: 435-438(2023)
- 作者机构：
  
  河北省胸科医院胸外科/河北省肺病重点实验室，河北石家庄 050041
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.09E022132
  CLC： R734.2
- Published：25 May 2023，
  
  Received：26 September 2022，
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彭海军,李义帅,张磊等.单孔胸腔镜下肺叶切除术治疗肺功能中重度减低的周围型肺癌的效果[J].局解手术学杂志,2023,32(05):435-438.

PENG Hai-jun,LI Yi-shuai,ZHANG Lei,et al.Effect of single-port thoracoscopic lobectomy in the treatment of peripheral lung cancer with moderate-to-severe reduction of lung function[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(05):435-438.
彭海军,李义帅,张磊等.单孔胸腔镜下肺叶切除术治疗肺功能中重度减低的周围型肺癌的效果[J].局解手术学杂志,2023,32(05):435-438. DOI： 10.11659/jjssx.09E022132.

PENG Hai-jun,LI Yi-shuai,ZHANG Lei,et al.Effect of single-port thoracoscopic lobectomy in the treatment of peripheral lung cancer with moderate-to-severe reduction of lung function[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(05):435-438. DOI： 10.11659/jjssx.09E022132.

摘要

目的

探讨单孔胸腔镜下肺叶切除术治疗肺功能中重度减低的周围型肺癌患者的效果。

方法

选取我院肺功能中重度减低的周围型肺癌患者86例，按照随机数字表法分为单孔组和三孔组，每组43例。单孔组患者采用单孔胸腔镜下肺叶切除治疗，三孔组采用常规三孔胸腔镜下肺叶切除术治疗。观察2组围术期指标，比较2组术前及术后3 d、7 d第1秒用力呼气容积占预计值的百分比（FEV1%pred）、用力肺活量占预计值的百分比（FVC%pred）、最大分钟通气量占预计值的百分比（MVV%pred）等肺功能指标，降钙素原（PCT）、肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）等炎症因子，T淋巴细胞亚群CD3

、CD4

/CD8

及并发症发生情况。

结果

与三孔组比较，单孔组术后下床活动及术后住院时间缩短，手术时间延长，术中出血量及术后3 d VAS评分降低，差异均有统计学意义（

0.05）。2组术后3 d及7 d的FEV1%pred、FVC%pred、MVV%pred均较术前降低（

0.05），术后7 d单孔组FEV1%pred、FVC%pred、MVV%pred高于三孔组（

0.05）。术后3 d，2组炎症因子均较术前升高（

0.05），且单孔组低于三孔组（

0.05）；术后7 d，2组血清PCT、TNF-α、CRP水平出现回落，且单孔组低于三孔组（

0.05）。术后3 d，2组CD3

、CD4

/CD8

均较术前降低（

0.05），且单孔组高于三孔组（

0.05）；术后7 d，2组CD3

、CD4

/CD8

均有回升，且单孔组高于三孔组（

0.05）。2组患者并发症发生率比较，差异无统计学意义（

0.05）。

结论

单孔胸腔镜下肺叶切除术治疗肺功能中重度减低的周围型肺癌安全、有效，能获得与常规三孔胸腔镜手术相近的疗效，其在机体炎症、免疫功能及术后早期恢复方面更具优势，且因其手术创伤小，切口小，患者更易接受。

Abstract

Objective

To investigate the effect of single-port thoracoscopic lobectomy in the treatment of patients with peripheral lung cancer and moderate-to-severe reduction of lung function.

Methods

A total of 86 patients with peripheral lung cancer and moderate-to-severe reduction of lung function in our hospital were selected and divided into the single-port group and three-port group by random number table method

with 43 cases in each group.Patients in the single-port group were treated with single-port thoracoscopic lobectomy

and patients in the three-port group were treated with conventional three-port thoracoscopic lobectomy.The perioperative indicators were recorded

and the pulmonary function indicators including the percent of predicted forced expiratory volume in one second (FEV1%pred)

percent of predicted forced vital capacity (FVC%pred)

and percent of predicted maximum minute ventilation (MVV%pred)

inflammatory factors including the procalcitonin (PCT)

tumor necrosis factor-α (TNF-α)

C-reactive protein (CRP)

T lymphocyte subsets including CD3

CD4

/CD8

before surgery and 3 days and 7 days after surgery

and complications in the two groups were compared.

Results

Compared with the three-port group

the single-port group had shorter postoperative ambulation time and postoperative hospital stay

longer operation time

lower intraoperative blood loss and VAS score 3 days after operation

with statistically significant differences (

0.05).The FEV1%pred

FVC%pred and MVV%pred 3 days and 7 days after surgery in the two groups were lower than those before surgery

the FEV1%pred

FVC%pred and MVV%pred 7 days after surgery in the single-port group were higher than those in the three-port group (

0.05).The inflammatory factors 3 days after surgery in the two groups were higher than those before operation (

0.05)

and those in the single-port group were lower than those in the three-port group (

0.05);the serum levels of PCT

TNF-α and CRP 7 days after surgery in the two groups decreased

and those in the single-port group were lower than those in the three-port group (

0.05).The CD3

CD4

/CD8

3 days after surgery in the two groups were lower than those before surgery (

0.05)

and those in the the single-port group were higher than those in the three-port group (

0.05);the CD3

CD4

/CD8

7 days after surgery in the two groups all increased

and those in the single-port group were higher than those in the three-port group (

0.05).There was no significant difference in the incidence of complications between the two groups (

0.05).

Conclusion

Single-port thoracoscopic lobectomy in the treatment of peripheral lung cancer with moderate-to-severe reduction of lung function is safe and effective

which can achieve similar curative effect to conventional three-port thoracoscopic surgery.It has advantages in inflammation

immune function and early postoperative recovery

and is more acceptable to patients for its small surgical trauma and incision.

关键词

单孔法三孔法胸腔镜手术肺叶切除周围型肺癌炎症因子T淋巴细胞亚群肺功能减低

Keywords

single-port surgerythree-port surgerythoracoscopic surgerylobectomyperipheral lung cancerinflammatory factorsT lymphocyte subsetsreduction of lung function

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