三种胸腔镜下肺叶切除术的手术方法及结果对比分析

Comparative analysis of three operative methods and results of thoracoscopic lobectomy

目的对比分析三种胸腔镜下肺叶切除术的手术方法及结果。方法 150例行胸腔镜下肺叶切除术患者,根据手术方法不同分为A组(单操作孔肺叶切除术)、B组(全胸腔镜肺叶切除术)和C组(胸腔镜辅助肺叶切除术),每组50例。观察对比三组临床指标(术中出血量、术后拔管时间、住院时间)及中转开胸情况。结果三组患者的术中出血量、术后拔管时间和住院时间比较差异无统计学意义(P>0.05)。A组中转开胸患者9例,中转开胸率为18%(9/50);B组中转开胸患者11例,中转开胸率为22%(11/50);C组中转开胸患者10例,中转开胸率为20%(10/50),组间对比差异无统计学意义(χ~2=0.250,P>0.05)。结论单操作孔肺叶切除术、全胸腔镜肺叶切除术、胸腔镜辅助肺切除术三种胸腔镜下肺叶切除术治疗效果无明显差异,可根据患者实际病情及术者手术熟练程度选择手术方法。

Objective To compare and analyze the three operative methods and results of thoracoscopic lobectomy. Methods A total of 150 patients undergoing thoraeoscopic loheetomy were divided by different operation methods into group A （uniportal lobectomy）, group B （thoraeoscopie lobectomy） and group C （thoraeoseopie laryngeal lobectomy）, with 50 cases in each group. Observation and comparison were made on clinical indicators （intraoperative bleeding volume, postoperative extubation time and hospitalization time） and thoracotomy-conversion situation between two groups. Results Three groups had no statistically significant difference in intraoperative bleeding volume, postoperative extubation time and hospitalization time （P〉0.05）. Group A had 9 thoracotomy-eonversion cases, With thoracotomy-eonversion rate as 18% （9/50）, group B had 11 thoracotomy-eonversion cases, with thoracotomy-conversion rate as 22% （11/50）, and group C had 10thoraeotomy-eonversion cases, with thoracotomy-conversion rate as 20% （10/50）. Their difference was not statistically significant （X2=0.250, P〉0.05）. Conclusion There are no significant difference between the three kinds of thoraeoscopic lobectomy of uniportal lobectomy, thoracoscopic lobeetomy and thoraeospie laryngeal lohectomy, and operation method should he chosen according to the actual condition of patients and surgical operation proficiency.