| Objective:To compare the conventional thoracotomy,Single-port VATS and Three-port VATS for the treatment of peripheral lung cancer in the Short-term effect and quality of life,and investigate the clinical value of three kinds of operation.Methods:Clinical data of 75 patients with peripheral lung cancer who underwent radical resection from January 2017 to January 2018 was retrospectively analyzed in our hospital.According to different surgical methods divide them into three groups,28 of them underwent three-port VATS(three-port group,n=28),15 cases underwent single-port VATS(single-port group,n=15),and the other 32 cases underwent conventional thoracotomy(conventional thoracotomy group,n=15).The clinical outcomes among the three groups including surgical duration,the number of lymph nodes dissected,intraoperative blood loss,total postoperative drainage,postoperative drainage time,postoperative pain score,postoperative complications,preoperative and 3 months of postoperative life quality were compared.The study was analyzed with SPSS21.0,measurement date was expressed by mean+/-standard deviation(`x±s),one factor analysis of variance was used for comparison.The multiple comparison between many groups was used SNK-q test,x~2 test was used to analyze the qualitative date,with P<0.05for the difference was statistically significant.Results:The operations of three groups were successfully completed.No perioperative death was observed.The surgical duration of three-port group was(130.47±32.51)min,the number of lymph nodes dissected was(13.06±2.17),intraoperative blood loss was(157.48±67.92)ml,total postoperative drainage was(1043.72±638.96)ml,postoperative drainage time was(4.21±1.67)d,postoperative pain score was(3.92±1.26)points,postoperative complications were arrhythmia in one case,subcutaneous emphysema in three cases.The surgical duration of single-port group was(148.23±34.16)min,the number of lymph nodes dissected was(12.98±2.09),intraoperative blood loss was(164.33±71.60)ml,total postoperative drainage was(1147.44±590.73)ml,postoperative drainage time was(4.54±1.38)d,postoperative pain score was(3.15±1.34)points,postoperative complications was pulmonary infection in one case.The surgical duration of conventional thoracotomy group was(107.83±29.94)min,the number of lymph nodes dissected was(13.11±2.75),intraoperative blood loss was(198.09±68.46)ml,total postoperative drainage was(1523.62±732.57)ml,postoperative drainage time was(7.13±1.89)d,postoperative pain score was(6.82±0.91)points,postoperative complications were arrhythmia in two cases,atelectasis in three cases,pulmonary infection in one case.Conventional thoracotomy group compared with the other two groups,there were significant differences in surgical duration,intraoperative blood loss,total postoperative drainage,postoperative drainage time,postoperative pain score(P<0.05),but there was no significant difference in the number of lymph nodes dissected,postoperative complications(P>0.05).Between three-port group and single-port group,there were significant differences in surgical duration,postoperative pain score(P<0.05),but there was no significant difference in the number of lymph nodes dissected,intraoperative blood loss,total postoperative drainage,postoperative drainage time,postoperative complications(P>0.05).The global quality declined in all patients at 3 months of postoperative(P<0.05).Both three-port group and single-port group had a better quality than conventional thoracotomy group in global quality,role functioning,social functioning,pain,pain in chest,and pain in arm or shoulder(P<0.05).Single-port group had a better quality than three-port group in pain,pain in chest(P<0.05).Conclusion:Compared with the conventional thoracotomy,video-assisted thoracoscopy(VATS)not only has less invasive,faster recovery and less postoperative pain,but has a better quality of life in the early stage after operation.In brief,video-assisted thoracoscopy(VATS)for peripheral lung cancer is safe.feasible and curative. |
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