单孔胸腔镜与传统开胸手术治疗胸腺瘤的疗效对比分析

Comparison of effi cacy between single-port thoracoscopy and traditional thoracotomy in thymoma

目的比较单孔胸腔镜与传统开胸手术在治疗胸腺瘤的疗效差异。方法收集行单孔胸腔镜治疗胸腺瘤的患者34例(单孔胸腔镜组)和同期行传统开胸手术治疗胸腺瘤的患者27例(传统手术组)。对两组患者临床资料行回顾性分析。结果单孔胸腔镜组2例因胸腔粘连严重,转为双孔胸腔镜治疗,未出现中转开胸的病例。单孔胸腔镜组在手术时间和术中出血量方面较传统手术组均降低(均P<0.05),在术后胸腔引流时间、术后并发症发生率、下床活动时间、术后住院时间和抗生素应用时间方面较传统手术组均减少(均P<0.05)。与传统手术组比较,单孔胸腔镜组术后用力肺活量(forced vital capacity,FVC)和秒用力呼气量(forced expiratory volume in 1 s,FEV1)下降幅度较少,变化平稳(均P<0.05)。结论对于胸腺瘤的治疗,单孔胸腔镜手术是一种安全有效且具有较少并发症的手术方式。

Objective To compare the efficacy between single-hole thoracoscopy and traditional thoracotomy in the treatment of thymoma.Methods The clinical data of 34 patients undergoing single-hole thoracoscopic surgery for thymoma(the single-hole thoracoscopic group)and 27 patients undergoing traditional thoracotomy for thymoma(the traditional surgery group)were collected and analyzed retrospectively.Results In the single-hole thoracoscopic group,two cases were transferred to the double-hole thoracoscopic treatment due to severe pleural adhesion,but no case was transferred to thoracotomy.The operation time was shorter and intraoperative blood loss was less in the single-hole thoracoscope group than those in the traditional surgery group(both P<0.05),and the postoperative thoracic drainage time,postoperative ambulation time,postoperative hospital stay and antibiotic application time were all shorter and postoperative complication rate was lower than those of the traditional surgery group(all P<0.05).Compared with the traditional surgery group,forced vital capacity(FVC)and forced expiratory volume in 1 s(FEV1)in the single-hole thoracoscope group decreased significantly and the change was stable(both P<0.05).Conclusion For the treatment of thymoma,single-pore video-assisted surgery is a safe and effective method with fewer complications.