摘要
目的探讨单孔全胸腔镜肺癌根治术在临床中的应用效果。方法回顾性分析北京大学深圳医院自2014年1月至2015年1月我院胸腔镜治疗原发性肺癌患者95例的临床资料,其中单孔全胸腔镜手术45例为观察组,传统三孔全胸腔镜手术50例为对照组,比较两组各项参数情况。结果两组手术顺利完成。两组手术时间、术中中转率、术中出血量、清扫淋巴结枚数及站数、术后胸腔引流量及术后病理Ⅰ期、Ⅱ期所占比例差异均无统计学意义(P>0.05)。观察组术后胸腔引流管引流时间及术后住院时间、术后疼痛情况均优于对照组(P<0.05),但观察组术后使用负压机引流时间比对照组长(P<0.05)。观察组总住院费用明显高于对照组,尤其是在术中贵重耗材使用上,并且存在更大的手术切口延期愈合及气道损伤风险(P<0.05)。对照组围手术期死亡1例。结论单孔全胸腔镜手术应用于肺癌根治术安全可行,加快了术后周转,减轻了患者术后疼痛,但气道损伤及伤口延期愈合风险更高,增加了贵重耗材的使用。
Objective To investigate the feasibility and safety of uniportal video-assisted thoracic surgery（VATS）for primary lung cancer.Methods We retrospectively analyzed the clinical data of 95 primary lung cancer patients in our hospital between January 2014 and January 2015.The patients were divided into an observation group（45 patients）and a control group（50 patients）.Standard thoracoscopy lobectomy was used in the control group.Uniportal thoracoscopy lobectomy was used in the trial group.The parameters of the two groups were observed.Results The surgeries of the two groups were successfully completed.There was no statistical difference in operative time,intraoperative transit rate,blood loss,number of lymph node dissection,thoracic drainage and pathology Ⅰ,Ⅱ period（P〉0.05）.Postoperative drainage tube time,postoperative hospital stay,postoperative pain in the observation group were better than those in the control group（P〈0.05）.But postoperative drainage time in the observation group was longer than that in the control group（P0.05）.Also,the total hospital costs,especially on the use of expensive consumables,during surgery in the observation group was higher.And there was a higher risk of delayed incision healing or airway injury（P〈0.05）in the observation group.One death in the control group during perioperative period occurred.Conclusion Uniportal VATS operation applied in radical operation for lung cancer is safe and feasible.It accelerates postoperative turnover,reduces postoperative pain.But there is a higher risk for airway injury or delayed wound healing,and an increase in use of medical consumptive stuff.
出处
《中国胸心血管外科临床杂志》
CAS
CSCD
2016年第4期346-351,共6页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
关键词
单孔
电视胸腔镜手术
肺癌根治术
Uniportal
Video-assisted thoracoscopic operation
Lung cancer
