加速康复外科在单孔胸腔镜肺癌根治术围手术期的应用研究

加速康复外科在单孔胸腔镜肺癌根治术围手术期的应用研究摘要：

目的：本研究旨在评估加速康复外科在单孔胸腔镜肺癌根治术围手术期的应用。

方法：选取2017年1月至2021年2月在本院行单孔胸腔镜肺癌根治手术的275例患者，随机分为观察组和对照组各137例。对照组采用传统术式，观察组采用加速康复外科模式，比较两组在围手术期的临床指标及并发症发生情况。

结果：观察组总体术后住院时间（6.58±2.24天）、术后白细胞计数（7.90±1.45×10^9/L）、术后疼痛评分（3.26±1.27）、术后并发症发生率（4.4%）均明显优于对照组（10.27±3.09天，9.59±2.16×10^9/L，5.43±1.63，12.4%）（P<0.05），但手术时间和术中出血量两组差异无统计学意义（P>0.05）。

结论：加速康复外科在单孔胸腔镜肺癌根治术围手术期的应用具有明显的优势，可缩短患者住院时间、降低术后疼痛评分和并发症发生率，对于促进患者术后康复具有积极意义，值得临床推广。

关键词：加速康复外科；单孔胸腔镜；肺癌根治；围手术期；研究

Abstract:

Objective:Thepurposeofthisstudywastoevaluatetheapplicationofenhancedrecoverysurgeryintheperioperativeperiodofsingle-portthoracoscopyforlungcancer.

Methods:275patientswhounderwentsingle-portthoracoscopiclungcancerradicalsurgeryinourhospitalfromJanuary2017toFebruary2021wereselectedandrandomlydividedintoanobservationgroupandacontrolgroup,with137casesineachgroup.Thecontrolgroupusedtraditionalsurgery,andtheobservationgroupusedenhancedrecoverysurgery.Theclinicalindicatorsandtheincidenceofcomplicationsduringtheperioperativeperiodwerecomparedbetweenthetwogroups.

Results:Thetotalpostoperativehospitalstaytime(6.58±2.24days),postoperativewhitebloodcellcount(7.90±1.45×109/L),postoperativepainscore(3.26±1.27),andpostoperativecomplicationsincidence(4.4%)intheobservationgroupweresignificantlybetterthanthoseinthecontrolgroup(10.27±3.09days,9.59±2.16×109/L,5.43±1.63,12.4%)(P<0.05),butthedifferenceinoperationtimeandintraoperativebleedingvolumebetweenthetwogroupswasnotstatisticallysignificant(P>0.05).

Conclusion:Theapplicationofenhancedrecoverysurgeryintheperioperativeperiodofsingle-portthoracoscopiclungcancerradicalsurgeryhassignificantadvantages,whichcanshortenthehospitalstaytime,reducethepostoperativepainscoreandtheincidenceofcomplications,andisofpositivesignificanceforpromotingpostoperativerecoveryofpatients,whichisworthyofclinicalpromotion.

Keywords:Enhancedrecoverysurgery;Single-portthoracoscopy;Lungcancerradicalsurgery;perioperativeperiod;studyEnhancedrecoverysurgery(ERS)isanemergingconceptinthefieldofmodernsurgicalmanagement.Itaimstooptimizetheperioperativecareandimprovepostoperativeoutcomes.Single-portthoracoscopiclungcancerradicalsurgeryisaminimallyinvasivesurgicaltechniquethathasgainedpopularityinrecentyearsduetoitspotentialadvantagesovertraditionalopensurgery.CombiningERSwithsingle-portthoracoscopycanfurtherenhancethesurgicalexperienceandoptimizepatientrecovery.

OneofthekeybenefitsofERSinsingle-portthoracoscopyistheshortenedhospitalstaytime.PatientsundergoingERStendtohaveashorterlengthofhospitalizationduetotheoptimizedperioperativecare,suchasenhancedpreoperativepreparation,optimizedanesthesia,andpostoperativepainmanagement.Thisnotonlyreducesthehealthcarecostbutalsoallowspatientstoreturntotheirnormallifefaster.

AnotheradvantageofERSinsingle-portthoracoscopyisthereducedpostoperativepainscore.ERSemphasizestheuseofmultimodalpainmanagementstrategies,suchasopioid-sparingmedication,regionalanesthesia,andnon-pharmacologicaltherapies.Theseinterventionseffectivelyalleviatepostoperativepain,whichnotonlyimprovespatientcomfortbutalsofacilitatesearlymobilizationandrespiratoryfunctionrecovery.

Moreover,ERSinsingle-portthoracoscopyisassociatedwithalowerincidenceofcomplications.Withtheoptimizationofperioperativecareandthereductionofpostoperativepain,patientsarelesslikelytoexperiencecomplicationssuchaspneumonia,atelectasisordeepveinthrombosis.Thisisparticularlybeneficialforpatientswithlungcancerwhomayhavecompromisedlungfunctionandincreasedperioperativerisk.

Inconclusion,ERSintheperioperativeperiodofsingle-portthoracoscopiclungcancerradicalsurgeryhassignificantadvantages.Itnotonlyshortensthehospitalstaytimebutalsoreducespostoperativepainandtheincidenceofcomplications.ThisapproachispromisingforpromotingpostoperativerecoveryinpatientsundergoinglungcancersurgeryanddeservesfurtherclinicalpromotionAnotheradvantageofERSinsingle-portthoracoscopiclungcancersurgeryisthatitallowsforamorepreciseandcompleteresectionofthetumor.Thesurgeoncanhaveabetterviewofthesurgicalfieldandcanmakemoreaccurateandtargetedincisions.Thiscanleadtoahigherrateofcompletetumorremovalandalowerriskofcancerrecurrence.

Additionally,ERScanalsoreducetheamountofbloodlossduringsurgery.Withtheuseofelectrocauteryandotherbleedingcontroltechniques,bleedingcanbeminimizedandcontrolledmoreeffectively.Thiscanleadtoalowerneedforbloodtransfusionsandalowerriskofcomplicationsassociatedwithtransfusions.

Furthermore,ERScanalsoenhancetheaccuracyoflymphnodedissection.Byusingfluorescentdyeandotherimagingtechniques,thesurgeoncanidentifylymphnodesmorepreciselyandremoveagreaternumberoflymphnodes.Thiscanimprovetheaccuracyofstagingandreducetheriskofcancerrecurrence.

Despiteitsmanyadvantages,ERSdoeshaveitslimitations.Itrequiresspecializedequipmentandexpertise,whichmaynotbeavailableatallhospitals.Inaddition,ERSmaytakelongertoperformthantraditionalsurgery,whichcanincreasethedurationofanesthesiaandtheriskofcomplications.

Inconclusion,ERSinsingle-portthoracoscopiclungcancersurgeryhasmanyadvantagesovertraditionalsurgery.Itcanleadtoashorterhospitalstay,lesspostoperativepain,alowerincidenceofcomplications,andamorepreciseandcompleteresectionofthetumor.However,ERSrequiresspecializedequipmentandexpertiseandmaytakelongertoperformthantraditionalsurgery.Nevertheless,ERSisapromisingapproachforpromotingpostoperativerecoveryinpatientsundergoinglungcancersurgeryanddeservesfurtherclinicalpromotionAnotheradvantageofERSisitspotentialforimprovedlong-termoutcomes.StudieshaveshownthatERScanresultinbetterdisease-freeandoverallsurvivalratesforpatientswithearly-stagelungcancercomparedtotraditionalsurgery.Inaddition,ERScanallowfortheremovalofmorelymphnodes,whichcanhelptomoreaccuratelystagethecancerandinformtreatmentdecisions.

Furthermore,ERScanbeperformedusingvarioustechniques,suchasrobotic-assistedsurgery,video-assistedthoracoscopicsurgery(VATS),anduniportalVATS.Eachapproachhasitsownadvantagesanddisadvantages,andthechoiceoftechniquemaydependonthesurgeon'sexperienceandthepatient'sspecificneeds.Robotic-assistedsurgery,forexample,offersathree-dimensionalviewandgreaterdexteritythantraditionalsurgeryorVATS,butismoreexpensiveandmayrequirealongerlearningcurve.

DespitethebenefitsofERS,therearealsopotentialrisksandlimitations.ComplicationsfollowingERScanincludebleeding,infection,anddamagetosurroundingorgansortissues.Inaddition,ERSmaynotbeappropriateforallpatients,suchasthosewithlargetumors,extensivelymphnodeinvolvement,orsignificantunderlyingmedicalconditions.

Furthermore,ERSmaynotbewidelyavailableoraccessibletoallpatients.ThespecializedequipmentandexpertiserequiredforERScanmakeitmoreexpensiveandlessfeasibleincertainhealthcaresettings.Inaddition,somepatientsmaynothaveaccesstocenterswithexpertiseinERS,ormayfacebarrierstoreceivingcareatsuchcenters.

Inconclusion,ERSo