Clinical Study Of Uniport Thoracoscopic Lobectomy For Non-small Cell Lung Cancer

Objective: To explore the feasibility and efficacy of uniportal thoracoscopic lobectomy for non-small cell lung cancer.Methods: From January 2016 to February 2017,the clinical records of 81 patients with non-small cell lung cancer who underwent thoracoscopic surgery in First Hospital Affiliated to Soochow University.Among them,38 patients underwent uniportal thoracoscopic lung cancer resection,defined as uniportal group,16 males and 22 females.43 patients underwent three-portal thoracoscopic lung cancer radical surgery,defined as three-portal group,22 males and 21 females.Two groups of patients were successfully completed thoracoscopic surgery,no intraoperative surgical changes,no perioperative death,all patients recovered well after operation.The operation time of the two groups,intraoperative lymph node dissection,the amount of blood loss,the pain score of first,third days after operation,the time of postoperative thoracic duct placement,the time of postoperative hospitalization and postoperative complications(pleural effusion,arrhythmia,pulmonary infection,pulmonary atelectasis and pulmonary embolism)were observed.Result: There was no statistical difference between the two groups before operation(P > 0.05).Compared with three-portal group,the operation time(166.87 + 34.15vs151.47 + 29.19)(P < 0.05)was slightly longer in uniportal group.However,the pain score on third day after surgery(3.11 + 0.80vs3.70 + 0.91),the postoperative chest tube placement(5.26 + 3.41vs7.05 + 3.46),and the postoperative hospital stay(6.58 + 3.87vs8.74 + 4.49)in single hole group was better than three-portal group,there was was statistically significant(P < 0.05).Meanwhile there was no statistically difference in number of lymph node dissection groups(5.87±1.17vs5.44±1.01),the number of lymph node dissection(11.89±3.46vs10.65±2.70),intraoperative bleeding(142.89±95.06vs129.53±110.45)ml,the first day postoperative pain score(4.95±.0.77vs4.95±0.81)and the incidence of complications(10.5%vs11.6%)between two group.Conclusion: The clinical efficacy of uniportal thoracoscopic lobectomy in the treatment of non-small cell lung cancer is worthy of recognition.The operation time was slightly longer than that in the three-portal group.There was no statistical difference between the three-portal in the operation of lymph node dissection,the amount of blood loss,the first day of pain score and the incidence of complications after operation.The third day postoperative pain score,the time after the operation of the thoracic cavity and the time of postoperative hospitalization were obviously superior to those of the three-portal group.Therefore,the application of uniportal thoracoscopic lobectomy in the treatment of non-small cell lung cancer is safe and feasible.It has the advantages of small surgical trauma,light postoperative pain,quick recovery and short hospital stay.It is worthy of clinical practice in Department of thoracic surgery.