关键词: 皮内缝合, 早期拔管, 肺癌, 单孔腔镜肺叶切除术, 切口愈合

Abstract: Objective To analyze the application effect of intradermal suturing combined with modified chest tube placement in single-port video-assisted thoracoscopic lobectomy for lung cancer and its impact on wound healing.Methods Clinical data of 222 lung cancer patients who underwent single-port thoracoscopic lobectomy at the Thoracic Surgery Department,Wuhan University People's Hospital Guanggu Branch between July 2020 and August 2023 were retrospectively analyzed.Patients were sequentially assigned by admission time to the control group (n=93,interrupted sutures + conventional tube placement) and the study group (n=129,intradermal sutures + modified tube placement).Follow-up lasted 1 month postoperatively to compare wound healing,postoperative pain,and scar cosmesis.Results The unplanned extubation rates of thoracic tubes in the study group and the control group were 3.10% and 7.53% respectively,and there was no statistically significant difference between the two groups (P>0.05).The postoperative catheter insertion time of the study group and the control group was (5.10±2.00) days and (6.80±1.72) days respectively,the postoperative hospital stay was (11.45±5.53) days and (13.91±6.82) days respectively,and the incision healing time was (6.81±2.51) days and (9.11±2.38) days respectively.The incision fat liquefaction rates were 2.33% and 11.83% respectively,and the incision infection rates were 2.33% and 13.98% respectively.There was a statistically significant difference between the two groups (P<0.05).The pain scores of the study group and the control group on the 3rd day after surgery were (7.06±1.75) points and (7.46±1.62) points respectively.There was a statistically significant difference between the two groups (P>0.05).One month after the operation,the scar score of the study group was lower than that of the control group.Among them,the Vancouver Scar Scale scores of the study group and the control group were (4.73±2.13) points and (9.55±2.20) points respectively,and the scar Scale scores of the patients and the observers were (12.54±4.32) points and (25.22±3.08) points respectively.There was a statistically significant difference between the two groups (P<0.05).Conclusion Intradermal suturing combined with modified chest tube placement facilitates wound healing,improves scar cosmesis,and enhances postoperative aesthetic outcomes in single-port thoracoscopic lobectomy for lung cancer.

Key words: intradermal suture, early extubation, lung cancer, single-aperture thoracoscopic lobectomy, incision healing