电视胸腔镜手术对周围型孤立性肺小结节的诊疗价值

Value of Video-Assisted Thoracoscopic Surgery in Diagnosis and Treatment of Peripheral Solitary Pulmonary Nodules

目的探讨电视胸腔镜手术对周围型孤立性肺小结节的诊疗价值。方法回顾性分析2019年9月-2021年5月在我院行手术治疗的60例周围型孤立性肺小结节患者的临床资料,根据其手术方案不同分为开胸组(n=30)和胸腔镜组(n=30),开胸组采用开胸手术治疗,胸腔镜组进行电视胸腔镜下肺楔形切除术,两组术中均切除部分组织以作快速冰冻病理检查,术后行病理切片检查。比较两组手术时间、术中出血量、术后胸腔引流管留置时间、术后并发症发生情况以及术中快速冰冻病理分型结果检出情况。结果胸腔镜组手术时间、术中出血量、术后胸腔引流管留置时间以及术后并发症发生率均明显少于开胸组(P<0.05)。以术后病理切片检出结果为标准,两组术中快速冰冻病理检查对病理分型的诊断符合率对比差异无统计学意义(P>0.05)。结论电视胸腔镜手术治疗周围型孤立性肺小结节具有手术操作时间短、创伤少、并发症发生率低等优点,且其诊断肺小结节病理分型的准确率较高,有良好的临床应用价值。

Objective To investigate the value of video-assisted thoracoscopic surgery in the diagnosis and treatment of peripheral solitary pulmonary nodules.Methods The clinical data of 60 patients with peripheral solitary pulmonary nodules who underwent surgical treatment in our hospital from September 2019 to may 2021 were retrospectively analyzed.The patients were divided into thoracotomy group(n=30)and video assisted thoracoscopic surgery(VATS)group(n=30)according to the operation plan.The thoracotomy group was treated with thoracotomy,and the VATS group was treated with video assisted thoracoscopic surgery.In two groups,part of the tissue was excised for rapid frozen pathological examination,and pathological section was performed after operation.The operation time,intraoperative blood loss,postoperative indwelling time of thoracic drainage tube,postoperative complications and detection of intraoperative rapid frozen pathological typing results were compared between the two groups.Results The operation time,intraoperative blood loss,postoperative indwelling time of thoracic drainage tube and the incidence of postoperative complications in VATS group were significantly less than the thoracotomy group(P<0.05).There was no significant difference between the two groups in the coincidence rate of intraoperative rapid frozen pathological examination for pathological classification(P>0.05).Conclusion Video assisted thoracoscopic surgery in the treatment of peripheral solitary pulmonary nodules has the advantages of less operation time,less trauma,low incidence of complications,and its diagnostic accuracy of pathological classification of pulmonary nodules is high,which has good clinical application value.