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| 单孔胸腔镜在老年肺结节患者治疗中的研究进展 |
| Advancements in Research on Single-Port Thoracoscopy for the Treatment of Elderly Patients with Pulmonary Nodules |
| 投稿时间：2025-05-26 修订日期：2025-07-21 |
| DOI： |
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| 中文关键词: 单孔 胸腔镜 老年 肺结节 |
| 英文关键词:single-port, thoracoscopy, elderly, pulmonary nodules |
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| 摘要点击次数: 264 |
| 全文下载次数: 18 |
| 中文摘要: |
| 随着胸腔镜技术的革新与老龄化社会的到来，单孔胸腔镜手术（Uniportal Video-Assisted Thoracic Surgery, Uni-VATS）在老年肺结节患者中的应用成为胸外科领域的研究热点。本文综述了近年来的相关研究进展，表明Uni-VATS凭借单一切口、创伤更小、术后疼痛轻、恢复快的优势，显著提高了老年患者的围手术期安全性与生活质量。研究证实，在严格把握适应症的前提下，Uni-VATS对早期肺癌、良性结节及转移性结节的切除均安全可行，尤其适用于合并基础疾病、肺功能减退的高龄患者。尽管存在操作角度受限等技术挑战，但器械的改进与术者经验的积累已显著提升手术成功率。长期随访显示，虽然Uni-VATS在肿瘤学疗效上与传统多孔VATS相当，但在术后疼痛控制、胸管留置时间及住院时间方面表现优于多孔VATS。多中心研究和荟萃分析进一步证实，单孔老年VATS患者术后疼痛评分更低，生活质量和满意度更高，尤其在术后早期恢复阶段的表现更为突出，促进老年患者快速康复（ERAS）。未来研究需聚焦于长期生存获益、更精准的老年患者筛选标准及机器人辅助单孔技术的整合应用 |
| 英文摘要: |
| With the innovation of thoracoscopy technology and the advent of an aging society, the application of Uniportal Video-Assisted Thoracic Surgery (Uni-VATS) in elderly patients with pulmonary nodules has become a research hotspot in the field of thoracic surgery. This article reviews the relevant research progress in recent years and shows that Uni-VATS has significantly improved the peroperative safety and quality of life of elderly patients with the advantages of a single incision, smaller trauma, light postoperative pain and faster recovery. The study confirmed that Uni-VATS is safe and feasible for the removal of early lung cancer, benign nodules and metastatic nodules under the premise of strictly grasping the indications, especially for elderly patients with underlying diseases and pulmonary dysfunction. Despite technical challenges such as limited operating angles, the improvement of instruments and the accumulation of surgeon"s experience have significantly improved the success rate of surgery. Long-term follow-up showed that although Uni-VATS was comparable to traditional porous VATS in terms of oncology efficacy, it was better than porous VATS in terms of postoperative pain control, chest indwelling time and hospitalization time. Multicenter research and meta-analysis further confirmed that patients with single-hole elderly VATS have lower postoperative pain scores, higher quality of life and satisfaction, especially in the early postoperative recovery stage, which promotes rapid recovery (ERAS) in elderly patients. Future research will focus on the benefits of long-term survival, more accurate screening criteria for elderly patients and the integrated application of robot-assist assisted single-hole technology. |
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