区县医院开展单孔胸腔镜手术治疗自发性气胸的疗效及可行性

Effect and feasibility of single-port video-assisted thoracoscopic surgery in treatment of spontaneous pneumothorax in primary hospital

目的探讨区县医院开展单孔胸腔镜手术治疗自发性气胸的疗效及可行性。方法分析2014年1月-2016年7月在我院胸外科行胸腔镜手术治疗的51例自发性气胸患者的病例资料,采用单孔胸腔镜手术组16例,三孔胸腔镜手术组35例,比较两组病例的手术时间、术中出血量、术后总引流量、胸管留置时间、术后住院天数、术后并发症情况;并对术后第1天,第3天和第30天疼痛程度进行评价。结果两组病例均在胸腔镜下完成手术,无中转开胸病例;两组病例在手术时间、胸管留置时间、术后住院天数上比较差异有统计学意义(P<0.05),在术中出血量、术后总引流量、并发症例数上比较差异无统计学意义(P>0.05),单孔组术后第1天和第3天的疼痛程度轻于三孔组(P<0.05)。结论在具备一定胸腔镜手术基础的区县级基层医院开展单孔胸腔镜手术治疗自发性气胸安全有效,是可行的。

Objective To investigate the effect and feasibility of single-port video-assisted thoracoscopic sur- gery in the treatment of spontaneous pneumatothorax in primary hospital. Methods From January 2014 to July 2016, 51 patients with spontaneous pneumothorax were collected. 16 patients underwent the single-port video-assisted thoracoscopic surgery, and 35 patients underwent the three-port video-assisted thoracoscope surgery. Their operating time, intraoperative blood loss, post-operative drainage, chest catheter indwelling time, postoperative hospital stay, postoperative complications and the postoperative pain index were compared between the two groups. Results All the operations in the two groups were accomplished successfully without additional conversion to thoracotomy. Com- pared to the three-port group, the single-port group had less in operating time, chest catheter indwelling time, postop- erative hospital stay, and lower VRS score of the first day and the third day postoperative pain. There was no statisti- cal difference in intraoperative blood loss, post-operative drainage, and postoperative complications between the two groups. Conclusion The single-port video-assisted thoracoscopic surgery is safe and feasible in treatment of sponta- neous pneumatothorax in primary hospital.