Optimization Of Lymph Node Dissection Procedure For Right-sided Radical Lung Cancer Under Thoracoscopy

ObjectiveTo explore the optimization of lymph node dissection process in right lung cancer radical surgery under thoracoscope.MethodsThe clinical VATS of 58 patients with right lung non-small cell lung cancer treated in our center from September 1,2020 to May 31,2021 were selected.According to the different methods of lymph node dissection,the seventh group was divided into optimized group(n=26)and routine group(n=32).The subjects in the routine group were tested by routine treatment methods,while the patients in the optimization group were treated by optimizing the treatment methods on the basis of the control group.The perioperative indicators,lymph node dissection,postoperative complications,postoperative recurrence were used as observation indicators to evaluate the effects of the two lymph node dissection schemes.ResultsPatients in both groups completed the operation before June 1,2021.The comparison of general data between the two groups was not statistically significant(P > 0.05).After treatment,there was no significant difference between the two groups in PT stage,PN stage and PTNM stage(p>0.05).In the optimized group,the operation time was(24.08±4.41)min,the intraoperative blood loss was(32.19±20.13)ml,the postoperative hospitalization time was(6.13±1.64)d,the extubation time was(2.91±1.10)d,and the drainage volume on the first day after operation was(189.21±129.664)ml.The total incidence of adverse reactions in the optimized group was 10.81%,which was much lower than that in the control group(26.32%,x2=4.818,P = 0.028).After surgical treatment in both groups,the number of lymph nodes cleared was 14.26±2.35 in the optimized group compared with10.07±2.13 in the control group,and the number of metastatic lymph nodes was3.59±1.25 in the optimized group compared with 2.76±0.68 in the control group,with a statistically significant difference between the groups by statistical analysis,p<0.05.The number of postoperative recurrence cases in the optimization group was 4 cases lower than the number of recurrence cases in the conventional group,and the difference in components was not significant by statistical analysis,p>0.05.ConclusionsWe propose that the optimized thoracoscopic lobectomy with lymph node dissection significantly shortens the bleeding during intraoperative lymph node dissection,the postoperative hospital stay,the time to remove the chest drain and reduces the incidence of postoperative complications,etc.In terms of lymph node dissection,it allows more lymph nodes to be dissected and reduces the postoperative recurrence rate.The treatment effect of this method is better than that of thoracoscopic lobectomy with lymph node dissection in the control group.Therefore,the application of optimized thoracoscopic adenocarcinoma lobectomy plus lymph node dissection in early-stage NSCLC patients has better safety and feasibility,and has high clinical application and promotion value.