Single- versus multiple-port thoracoscopic lobectomy for lung cancer: a propensity-matched study
Single- versus multiple-port thoracoscopic lobectomy for lung cancer: a propensity-matched study
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单孔胸腔镜肺叶切除术与多孔胸腔镜肺叶切除术治疗肺癌：一项倾向匹配研究
DOI：
10.1093/ejcts/ezv358
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发表时间：
2016-01-01
影响因子：
3.4
通讯作者：
Wang, Qun
中科院分区：
文献类型：
--
作者：
Shen, Yaxing;Wang, Hao;Wang, Qun
本研究对2013年10月至2014年10月复旦大学中山医院胸外科连续411例非小细胞肺癌患者行电视胸腔镜单端口(SP)和多端口(MP)电视胸腔镜手术(VATS)。采用倾向性配对分析，结合术前临床特征，比较SP和MP两种术式治疗非小细胞肺癌的围手术期疗效和安全性。2013年10月至2014年10月，SP组115例，MP组296例。在这项回顾研究中，倾向匹配产生了100对。术中肺叶切除时间SP组明显少于MP组(65.7±14.8vs81.3+/-13.6，P&0.001)，而淋巴结清扫时间SP组明显长于MP组(29.6+/-16.7vs17.4+/-13.3，P&t；0.001)。两组手术总时间、术中失血量(55.1±9.0mlvs 58.7±7.1ml，P=0.22)和术后住院天数(4.7±1.2d vs5.3±1.4d，P=0.05)相似。术后，SP组和MP组的并发症和死亡率相似，与传统的VATS相比，SP VATS肺叶切除术在非小细胞肺癌手术中显示出更好的安全性和有效性。需要基于更大的人群和更好的方法进行进一步的研究，以确定其对患者的进一步好处。
In this retrospective study, we aimed to compare single-port (SP) and multiport (MP) video-assisted thoracoscopic surgery (VATS) for the surgical resection of non-small-cell lung cancer (NSCLC).Between October 2013 and October 2014, a total of 411 consecutive NSCLC patients who underwent VATS lobectomy in the Department of Thoracic Surgery, Zhongshan Hospital of Fudan University, were enrolled. Propensity-matched analysis, incorporating preoperative clinical features, was used to compare the perioperative outcomes and analyse the safety and efficacy between SP and MP VATS lobectomies for NSCLCs.There were 115 patients in the SP group, and 296 patients in the MP group from October 2013 to October 2014. Propensity matching produced 100 pairs in this retrospective study. During the operation, the lobectomy took less time in the SP than in the MP (65.7 +/- 14.8 vs 81.3 +/- 13.6, P < 0.001) group, while the duration of lymphadenectomy was longer in the SP group (29.6 +/- 16.7 vs 17.4 +/- 13.3, P < 0.001). The total operation duration, the volume of estimated blood loss (55.1 +/- 9.0 ml vs 58.7 +/- 7.1 ml, P = 0.22) and the length of postoperative hospital stay (4.7 +/- 1.2 days vs 5.3 +/- 1.4 days, P = 0.05) were similar between the two groups. Postoperatively, SP and MP groups showed similar results in terms of morbidity and mortality.In comparison with conventional VATS, SP VATS lobectomy showed better safety and efficacy in the surgical resection of NSCLCs. Further studies based on larger populations and better methodology are required to determine its further benefits towards patients.