| 摘要: |
| 目的探讨单操作孔胸腔镜手术治疗肺部结节病变的安全性及临床效果。方法选择2010年7月至2015年5月采用单操作孔胸腔镜下切除肺部结节病变患者76例为观察组，同时选取同一时间段采取三孔术式的58例患者为对照组，观察两组患者手术时间、术中出血量、胸腔引流管引流量、引流管拔除时间、术后平均住院时间；术后采用疼痛量表（VAS）评估患者疼痛情况。结果观察组行肺段切除58例，肺叶切除18例，行淋巴结清扫26例；平均手术时间（58.7±21.3）min，术中出血（35.2±14.5）ml，术后第1天胸腔引流管引流量（260±150）ml，引流管拔除时间（4.3±1.6）d，术后住院时间（6.8±2.3）d。对照组平均手术时间（93.9±25.5）min，术中出血（110.5±38.5）ml，术后第1天胸腔引流管引流量（270±170）ml，引流管拔除时间（5.2±1.3）d，术后住院时间（7.4±2.8）d，两组手术时间、术中出血量、术后第1天引流量、引流管拔除时间及术后住院时间差异均无统计学意义（均P＞0.05）。观察组患者术后8d，第1、3、5天VAS评分2.38±0.94、2.08±0.84、1.68±0.82、1.18±0.54；对照组患者术后8d，第1、3、5天VAS评分3.48±1.14、3.14±0.94、2.68±0.89、1.98±0.74。两组术后相同时间点VAS评分比较，对照组均小于观察组（均P＜0.01）。两组患者均无严重并发症发生；随访时间（33.1±12.8）月，无一例复发。结论单操作孔胸腔镜手术治疗肺部结节病变安全、可靠，术后并发症少、患者恢复快。 |
| 关键词: 胸腔镜 肺部结节病变 单操作孔 |
| DOI： |
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| 基金项目:浙江省台州市黄岩区科技局基金 |
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| Uniportal video-assisted thoracoscopic surgery for pulmonary nodular lesions |
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CHEN Wei, LI Wentao, YANG Zeshan, ZHANG Jichen, ZHENG Senzhong, CHEN Yang, LI Anan, ZHOU Yanfei
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Huangyan Hospital Affiliated of Wenzhou Medical University
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| Abstract: |
| Objective To assess the safety and efficacy of uniportal video-assisted thoracoscopic surgery (UVATS) for pulmonary nodular lesions. Methods Seventy six patients with pulmonary nodular lesions received UVATS and dissection of systematic lymph nodes based on the results of frozen pathology From July 2010 to May 2015. Results Among 76 patients, 58 underwent lung segmentectomy, 18 underwent lung lobeectomy, 26 received dissection of systematic lymph nodes. The operation time was (58.7±21.3) minutes, the intraoperative blood loss was (35.2±14.5) ml, the volume of drainage was 260± 150）ml, the VAS score was (2.3±0.9), and the postoperative hospital stay was (6.8±2.3) days. The VAS scores were significantly lower than those in the control group (three ports VATS) (P＜0.01), while there were no differences in the volume of drainage, the
operation time and the blood loss between two groups (both P ＞0.05). All the patients achieved postoperative recovery and no severe complication occurred. All the patients in this study were followed up regularly for an average of 33.1 months and there was no recurrence. Conclusion The UVATS is a safe and feasible method in the treatment of pulmonary nodular lesions and dissection of systematic lymph nodes, and with the advantages of lower morbidity and rapid postoperative recovery. |
| Key words: Video-assisted thoracoscopic surgery Pulminary nodular diseases Uniport |
