Clinical value between axillary thoracotomy and video-assisted thoracoscopic lobectomy in the treatment of patients with lung cancer_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WANG Yi , LI Ji , LUO Lei , YANG Yanhui ,  XIE Xiaoyang

Department of Thoracic Surgery, The First People's Hospital of Neijiang, Neijiang Affiliated Hospital of Chongqing Medical University, Neijiang, 641000, Sichuan, P.R.China;

Corresponding?author：

XIE Xiaoyang, Email: 13990559066@163.com

Keywords：

Radical operation of lung cancer; video-assisted thoracic surgery; subaxillary small incision thoracotomy

DOI：

10.7507/1007-4848.201608055

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To compare the subaxillary small incision thoracotomy (SSIT) with video-assisted thoracic surgery (VATS) for patients with lung cancer. Methods Retrospective analysis of 142 patients with lung cancer in Department of Thoracic Surgery, The First People's Hospital of Neijiang from January 2014 to April 2016 was conducted. There were 86 males and 56 females, aged 40-77 years. Patients were divided into a VATS group (n=72) and a SSIT group (n=70). The following postoperative data were evaluated: operation time, number of dissected lymph nodes, intraoperative bleeding, postoperative chest drainage volume, drainage duration, postoperative ambulation time, average hospital stay, postoperative complications, hospitalization cost, early postoperative incision pain (visual analogue scale, VAS) and other indicators. Results There were no statistically significant differences between the two groups in the operation time (120.8±20.4 minvs. 126.2±21.6 min,P=0.124), the dissected lymph node (11.1±2.0vs. 11.4±1.9,P=0.333) and the postoperative complications rate (13.9% vs. 15.7%, P=0.759). Laparoscopic intraoperative bleeding and postoperative drainage volume were significantly less in the VATS group than those in the SSIT group (123.2±26.9 mlvs. 156.4±24.0 ml,P<0.001; 227.0±75.5 mlvs. 334.3±89.1 ml,P<0.001). Postoperative drainage duration, postoperative ambulation time and hospital stay were shorter in the VATS group than those in the SSIT group (2.5±0.5 dvs. 3.1±0.6 d, 1.5±0.5 dvs. 2.2±0.6 d, 6.5±0.5 dvs. 7.4±0.6 d, allP<0.001). The average hospitalization cost of the VATS group was significantly higher than that of the SSIT group (42 338.9±8 855.7 yuanvs. 32 043.7±7 178.1 yuan,P<0.001). There was no significant difference in the operation cost and anesthesia cost between the two groups (P>0.05). The early postoperative pain of laparoscopic group was less, but the difference was not statistically significant (P>0.05). Conclusion The hospitalization cost of the SSIT is lower than that of thoracic surgery, which may be beneficial to the appilication in primary hospitals.

Citation： WANG Yi, LI Ji, LUO Lei, YANG Yanhui, XIE Xiaoyang. Clinical value between axillary thoracotomy and video-assisted thoracoscopic lobectomy in the treatment of patients with lung cancer. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(11): 844-848. doi: 10.7507/1007-4848.201608055 Copy

1.	支修益, 石遠凱, 于金明. 中國原發性肺癌診療規范(2015 年版). 中華腫瘤雜志, 2015, 37(1): 67-68.
2.	車國衛, 劉倫旭, 石應康. 加速康復外科臨床應用現狀與思考. 中國胸心血管外科臨床雜志, 2016, 23(3): 211-215.
3.	Hirai K, Takeuchi S, Usuda J. Single-port video-assisted thoracic surgery for early lung cancer: initial experience in Japan. J Thoroc Dis, 2016, 8(3): 44-50.
4.	蒲強, 馬林, 車國衛, 等. 單向式胸腔鏡肺葉切除安全性及技術可行性研究——附 1040 例報告. 四川大學學報 (醫學版), 2013, 44(1): 109-113.
5.	宋志芳, 韓兆杰, 林琳, 等. SF-36 量表評價胸外科住院患者生活質量的信度和效度. 中國胸心血管外科臨床雜志, 2014, 21(2): 164-167.
6.	張海, 吳昊, 牟志民, 等. 單孔與三孔法電視胸腔鏡治療原發性肺癌效果的病例對照研究. 中國胸心血管外科臨床雜志, 2016, 23(4): 346-351.
7.	郝志鵬, 蔡奕欣, 付圣靈, 等. 單孔與三孔胸腔鏡肺癌根治術對患者術后疼痛及短期生活質量的對比研究. 中國肺癌雜志, 2016, 19(3): 122-128.
8.	Lyscov A, Obukhova T, Ryabova V, et al. Double-sleeve and carinal resections using the uniportal VATS technique: a single centre experience. J Thorac Dis, 2016, 8(3): 35-41.
9.	莫輝勝, 潘毓標, 韋力. Ⅰ期肺癌患者的單向式全胸腔鏡肺葉切除術效果研究. 中國現代手術學雜志, 2016, 20(1): 30-33.
10.	Pishchik VG, Zinchenko EI, Obornev AD, et al. Video-assisted thoracoscopic anatomic lung resection: experience of 246 operations. Khirurgiia, 2016, 1(2): 10-15.
11.	張志輝, 陳國喜, 邱玉清. 全胸腔鏡肺葉切除術中利用常規器械技術替代一次性高值材料的實踐與體會. 廣東醫學院學報, 2012, 30(2): 148-150.
12.	丁國強, 張瑛, 白舒, 等. 經濟欠發達地區全胸腔鏡肺葉切除術初步體會. 中國微創外科雜志, 2010, 10(6): 508-509.
13.	尉連成, 張明遠, 牛子民. 腋下小切口手術治療肺癌 68 例體會. 中國微創外科雜志, 2005, 5(12): 1003.
14.	彭忠民, 李猛, 孟龍, 等. 微創技術在肺癌支氣管/肺動脈成型術中的應用探討. 中國肺癌雜志, 2009, 12(11): 1139-1142.
15.	周中新, 姜波, 劉京松, 等. 胸腔鏡手術中胸膜腔粘連處理體會. 齊齊哈爾醫學院學報, 2014, 35(24): 3618-3620.
16.	Suda T, Ashikari S, Tochii S, et al. Single-incision subxiphoid approach for bilateral metastasectomy. Ann Thorac Surg, 2014, 97(2): 718-719.
17.	陽鵬, 吳智寧, 梁劍平, 等. Muscle-sparing 小切口、常規后外側切口及胸腔鏡三孔手術切口在肺癌根治術中的療效比較. 中國現代手術學雜志, 2016, 20(1): 25-29.
18.	Asteriou C, Lazopoulos A, Rallis T, et al. Video-assisted thoracic surgery reduces early postoperative stress. A single-institutional prospective randomized study. Ther Clin Risk Manag, 2016, 12(12): 59-65.
19.	龍浩, 林志潮, 林勇斌, 等. 胸腔鏡與小切口開胸肺切除術后生活質量的對比性研究. 中國微創外科雜志, 2008, 83(2): 137-139.
20.	Cheng K, Zheng B, Zhang S, et al. Feasibility and learning curve of uniportal video-assisted thoracoscopic segmentectomy. J Thorac Dis, 2016, 8(3): 29-34.
21.	楊梅, 樊駿, 周紅霞, 等. 胸腔鏡肺癌肺葉切除術后 16F 較 28F 胸腔引流管應用的臨床優勢. 中國肺癌雜志, 2015, 18(8): 512-517.

1. 支修益, 石遠凱, 于金明. 中國原發性肺癌診療規范(2015 年版). 中華腫瘤雜志, 2015, 37(1): 67-68.
2. 車國衛, 劉倫旭, 石應康. 加速康復外科臨床應用現狀與思考. 中國胸心血管外科臨床雜志, 2016, 23(3): 211-215.
3. Hirai K, Takeuchi S, Usuda J. Single-port video-assisted thoracic surgery for early lung cancer: initial experience in Japan. J Thoroc Dis, 2016, 8(3): 44-50.
4. 蒲強, 馬林, 車國衛, 等. 單向式胸腔鏡肺葉切除安全性及技術可行性研究——附 1040 例報告. 四川大學學報 (醫學版), 2013, 44(1): 109-113.
5. 宋志芳, 韓兆杰, 林琳, 等. SF-36 量表評價胸外科住院患者生活質量的信度和效度. 中國胸心血管外科臨床雜志, 2014, 21(2): 164-167.
6. 張海, 吳昊, 牟志民, 等. 單孔與三孔法電視胸腔鏡治療原發性肺癌效果的病例對照研究. 中國胸心血管外科臨床雜志, 2016, 23(4): 346-351.
7. 郝志鵬, 蔡奕欣, 付圣靈, 等. 單孔與三孔胸腔鏡肺癌根治術對患者術后疼痛及短期生活質量的對比研究. 中國肺癌雜志, 2016, 19(3): 122-128.
8. Lyscov A, Obukhova T, Ryabova V, et al. Double-sleeve and carinal resections using the uniportal VATS technique: a single centre experience. J Thorac Dis, 2016, 8(3): 35-41.
9. 莫輝勝, 潘毓標, 韋力. Ⅰ期肺癌患者的單向式全胸腔鏡肺葉切除術效果研究. 中國現代手術學雜志, 2016, 20(1): 30-33.
10. Pishchik VG, Zinchenko EI, Obornev AD, et al. Video-assisted thoracoscopic anatomic lung resection: experience of 246 operations. Khirurgiia, 2016, 1(2): 10-15.
11. 張志輝, 陳國喜, 邱玉清. 全胸腔鏡肺葉切除術中利用常規器械技術替代一次性高值材料的實踐與體會. 廣東醫學院學報, 2012, 30(2): 148-150.
12. 丁國強, 張瑛, 白舒, 等. 經濟欠發達地區全胸腔鏡肺葉切除術初步體會. 中國微創外科雜志, 2010, 10(6): 508-509.
13. 尉連成, 張明遠, 牛子民. 腋下小切口手術治療肺癌 68 例體會. 中國微創外科雜志, 2005, 5(12): 1003.
14. 彭忠民, 李猛, 孟龍, 等. 微創技術在肺癌支氣管/肺動脈成型術中的應用探討. 中國肺癌雜志, 2009, 12(11): 1139-1142.
15. 周中新, 姜波, 劉京松, 等. 胸腔鏡手術中胸膜腔粘連處理體會. 齊齊哈爾醫學院學報, 2014, 35(24): 3618-3620.
16. Suda T, Ashikari S, Tochii S, et al. Single-incision subxiphoid approach for bilateral metastasectomy. Ann Thorac Surg, 2014, 97(2): 718-719.
17. 陽鵬, 吳智寧, 梁劍平, 等. Muscle-sparing 小切口、常規后外側切口及胸腔鏡三孔手術切口在肺癌根治術中的療效比較. 中國現代手術學雜志, 2016, 20(1): 25-29.
18. Asteriou C, Lazopoulos A, Rallis T, et al. Video-assisted thoracic surgery reduces early postoperative stress. A single-institutional prospective randomized study. Ther Clin Risk Manag, 2016, 12(12): 59-65.
19. 龍浩, 林志潮, 林勇斌, 等. 胸腔鏡與小切口開胸肺切除術后生活質量的對比性研究. 中國微創外科雜志, 2008, 83(2): 137-139.
20. Cheng K, Zheng B, Zhang S, et al. Feasibility and learning curve of uniportal video-assisted thoracoscopic segmentectomy. J Thorac Dis, 2016, 8(3): 29-34.
21. 楊梅, 樊駿, 周紅霞, 等. 胸腔鏡肺癌肺葉切除術后 16F 較 28F 胸腔引流管應用的臨床優勢. 中國肺癌雜志, 2015, 18(8): 512-517.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical value between axillary thoracotomy and video-assisted thoracoscopic lobectomy in the treatment of patients with lung cancer

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content