经济欠发达地区电视胸腔镜手术治疗体会

Vedio-assisted thoracoscopic surgery in underdevelopment area

目的探索在经济欠发达地区最大限度降低手术费用(接近常规开胸手术费用)开展电视胸腔镜手术(video assisted thoracoscopic surgery,VATS)技术的可行性,以及具体手术方法。方法采用同时期内相同或类似种类的胸部手术病人,随机分为实验组(VATS组)和对照组(开胸手术组),比较VATS组与开胸组在手术中出血量、手术时间、术后引流量、住院时间、住院总费用差异。结果手术时间对比无显著差异,手术中出血量、手术后胸管引流量、住院天数、手术后并发症对比差异显著,住院总费用对比差异不显著。结论通过改进常规VATS手术技术,不使用一次性器械的电视胸腔镜手术是可行的。

Objective To investigate the feasibility and operation procedure of video-assisted thoracoscopie surgery （VATS） in underdevelopment area with the lowest costs （ as costs of conventional thoracic surgery）. Methods Patients with same or similar thoracic diseases in the same period were divided into experiment group （ VATS group） and control group （thoracic surgery group） randomly. To compare the blood loss during operation, operative time, postoperative drainage, hospitalization days and total hospitalization costs in two groups. Results There was significant difference in blood loss during operation, postoperative drainage, hospitalization days and complications after operation between two groups. No significant difference was found in operative time or total hospitalization costs. Conclusion It is feasible to perform VATS with disposable thoracotomy instruments by modified techniques.