| Objectives:To compare the short-term efficacy of modified single-operated port and single-port video-assisted thoracoscopic radical resection for non-small cell lung cancer.To explore the clinical application value of modified single-operated port thoracoscopic surgery.Methods: A total of 82 patients who were admitted to the geriatric thoracic surgery Department of the First Affiliated Hospital of Kunming Medical University from October 2021 to October 2022 and required lobotomy were randomly grouped according to different surgical methods.The patients receiving modified single-operated port thoracoscopic radical resection for lung cancer were classified as the modified single-operated port group and the patients receiving single-port thoracoscopic radical resection for lung cancer were classified as the single-port group.There were 41 patients in each group.The basic clinical data,pathological types and stages,surgical related indicators and postoperative complications were compared between the two groups.Results: A total of 73 patients were finally included in the study analysis(35cases in the modified single-operated port group and 38 cases in the single-port group).All operations were successfully completed in the modified single-operated port group and the single-port group,all patients underwent thoracoscopic lobectomy and systematic mediastinal lymph node dissection,and there were no cases of conversion to thoracotomy for intraoperative massive bleeding,second thoracotomy after operation,or perioperative death.Two groups in age,sex,tumor in patients with lung,pathological type and pathological staging,tumor differentiation degree has no statistically significant difference(p > 0.05).The lymph node in operation time,intraoperative blood loss,amount,flow rate and postoperative chest tube indwelling time,length of hospital stay,postoperative patients need additional number of analgesia,differences in the two groups has no statistical significance(p > 0.05),pain VAS score on the day of surgery [4(3,4)vs 5(5,6),points,p < 0.001] and postoperative day 1 [4.5(3,5)vs.5(5,6),points,p < 0.001] single-port group is lower than the modified single-operated port group,statistically significant difference(p <0.05),while in 3 days and 5 days after two groups of postoperative pain VAS score differences had no statistical significance(p > 0.05).The number of intraoperative clips used in the two groups(1.29±1.99 vs.0.34±0.77,p = 0.009)was significantly more in the single-port group than in the modified single-operated port group(p <0.05).The number of clips used during different lobectomy was compared between the two groups.No clips were used during left upper and left lower lobectomy,while the number of clips used during right middle lobectomy in the single-port group was significantly higher than that in the modified single-operated port group(2.33±2.54 vs.0.57±0.98,p = 0.048),statistically significant difference(p < 0.05),while in the upper lobe and right pulmonary lobe resection,two groups of patients with vascular clamp using quantity differences have no statistical significance(p > 0.05).In the comparison of two groups of patients with postoperative complications,no statistically significant difference(p > 0.05).Conclusions: 1.Modified single-operated port thoracoscopic surgery combines the advantages of single-port and traditional single-operated port thoracoscopic surgery.The intraoperative visual field and surgical operation are closer to the traditional thoracotomy,and the surgical method has certain angle advantages,and it is easier to pass through blood vessels and trachea when using stapler,which has good surgical effect,operation safety and practicability.2.Modified single-operated port thoracoscopic surgery has little effect on postoperative pain and does not bring more trauma to patients.3.Modified single-operated port is an alternative surgical method when single-port video-assisted thoracoscopic surgery is difficult to operate. |
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