肺部疾病中电视胸腔镜手术与常规开胸手术的对比研究

A COMPARATIVE STUDY OF VIDEO-ASSISTED THORACIC SURGERY VERSUS ROUTINE OPEN THORACOTOMY IN LUNG DISEASES

目的 :在肺部疾病中应用电视胸腔镜手术 (VATS)与常规开胸手术比较显示其优越性。方法 :施行VATS40例 ,其中胸腔镜辅助小切口手术 (VAMT) 2 0例 (研究组 ) ;同期施行常规开胸手术 40例 (对照组 ) ,手术疾病均包括自发性气胸及肺部占位性病变等。比较两组病人围手术期情况。结果 :研究组与对照组比较 ,手术效果满意 ,无术后并发症及死亡。手术时间〔分别为 ( 140 .78± 6 0 .34) ,( 2 15 .76± 6 2 .34)min〕 ,失血量〔分别为( 2 6 0 .41± 16 5 .37) ,( 6 80 .38± 341.72 )ml〕及手术恢复、胸液量、胸管置留时间、术后住院天数等 ,均有显著性差异 (均为P <0 .0 1)。结论 :电视胸腔镜手术具有创伤小、出血少、疼痛轻、手术时间短、疗效可靠、恢复快、并发症少、住院时间短及符合美容要求等优点 ,结果令人满意。

To show advantage of video-assisted thoracic surgery(VATS) compared with routine open thoracotomy in lung diseases.Methods:Forty patients successfully underwent VATS. Among them, 20 cases received video-assisted minithoractomies(VAMT) simultaneously (test group );During the same period 40 patients underwent routine open thoracotomies (control group) . The diseases were spontaneous pneumothorax and lung tumors.Results: The results for VATS were compared those for routine open thoracotomies. There were no operative mortality and postoperative complications in test group. The mean operating time was(140.78±60.34)min for test group and(215.76±62.34)min for control group .The mean operating blood loss was (260.41±165.37)ml for test group and(680.38±341.72)ml for control group. The mean duration of chest tube drainage was (2.39±0.80)d for test group and(4.88±1.47)d for control group. The mean postoperative hospital stay was(10.78±2.88) d for test group and(15.37±4.37) d for control group. The difference in the above parameters between two groups was significant(all P <0.01).Conclusion: It is suggested that VATS is a safe, effective and less traumatic procedure in the treatment of some lung diseases.