电视纵隔镜与传统纵隔镜在临床应用中的比较

Video-mediastinoscopy vs. standard mediastinoscopy in clinical application

目的 比较电视纵隔镜手术 (VM)与传统纵隔镜手术 (SM)在胸部疾病临床应用中的价值。方法 回顾性分析纵隔镜手术 10 0例 ,其中VM组 5 4例 ,SM组 46例。比较两组手术时间、术后并发症以及纵隔疑难疾病的诊断率和肺癌治疗前分期的准确性。两组中单纯接受纵隔镜检查的病人还进行了术后住院天数的比较。结果 VM组手术时间为 ( 5 3 9± 17 2 )min ,SM组为 ( 6 9 4± 2 4 7)min ,两组比较t=2 0 5 ,P <0 0 5。VM组术后并发症发生率 ( 0 )及术后住院天数 ( 2 5 8± 1 6 7)d均少于SM组 ,但两组差异无显著性 (P >0 0 5 )。两组在纵隔疑难疾病诊断率和肺癌治疗前分期准确性方面差异无显著性 (P >0 0 5 )。结论 与传统纵隔镜手术相比 ,电视纵隔镜手术视野更清晰 ,双手操作更加灵活、舒适 ,可作为诊断纵隔疑难疾病和明确肺癌术前分期的常规方法。

Objective: To compare the clinical value of video-mediastinoscopy (VM) and standard mediastinoscopy(SM) in diagnosis of thoracic diseases. Methods: The clinical data of 100 patients with mediastinoscopy were studied retrospectively. Of them, 54 patients underwent VM, and 46 patients underwent SM. The operative parameters including operating time, complications and post-operative hospital stay, the diagnosis accuracy of undifferentiated mediastinal diseases and the accuracy of perioperative staging of lung cancer were compared. Results: The average operating time in VM group was (53.9±17.2) mins, which was less than that in SM group (69.4±24.7)mins (t=2.05,P<0.05). No significant difference was found between the two groups in complications, post-operative hospital stay, and the diagnosis accuracy of undifferentiated mediastinal diseases and the accuracy of perioperative staging of lung cancer. Conclusion: Compared with the standard mediastinoscopy, video-mediastinoscopy offers a better view of operative field. Furthermore, the maneuvers are more agility and comfortable by operating with both hands. It seems to be a reliable technique for the diagnosis and staging of thoracic disease.