胸部小切口在胸心外科手术中的临床应用(英文)

THE APPLICATION OF MINIMAL INCISION THORACOTOMY IN THE THORACIC AND CARDIOVASCULAR SURGERY

目的:为了改进传统的开胸手术切口,减少手术创伤,探索小切口在胸部手术中的应用价值。方法:采用保留胸壁肌肉、不切除肋骨的胸部小切口(切口平均长度12.5cm)及胸骨下段小切口(切口长度7cm),对203例胸心疾病的患者施行了肺叶切除、肺楔形切除、肺癌根治、纵隔肿瘤摘除、脓胸清创、血胸止血清创及纤维板剥离、动脉导管结扎、食管良性疾病等常见胸心外科手术,胸部小切口组与同期传统标准开胸切口手术组203例,作手术切口大小、术中失血量、术后胸腔引流量、术后止痛药应用、术后输血量、术后平均住院日等做比较。结果:203例病人术中未发生严重并发症,切口小,出血少,输血少,术后恢复快(P<0.001)。结论:由于手术切口小,不切断胸壁肌肉,年轻病人不切除肋骨,创伤小,出血少,愈合快,美观;术后术侧上肢活动及肩关节功能影响小、恢复快。

Objective:To improve upon traditional thoracic incision and to lessen surgical impairment, the application of thoracic small incision to thoracic surgery was explored. Methods: Minimal incision was applied either with thoracic muscles in reserve (average length of incision was 10 ± 3cm) ,or from the lower part of stemum(average length was 7cm). To 203 cases of thoracic and cardiovascular diseases, who were administered with series of common thoracic surgical treatments, pulmonary wedge resection and lobectomy, lung cancer radical resection, extirpation of mediastinum neoplasm, depuration of purulent thorax and ablation of fibrous plate, ligation of patent duc-tus arteriosus and therapy of esophageal benign disease. Results: There were no complications occurred in the 203 cases in operation or after operation. The incision was small and the patients were recuperated rapidly. Conclusions; As a result of micro incision, without transecting muscles, and without amputating ribs in young patients, the surgery wound was slight with few quantity of bleeding, the incision was small and fine, the movement of upper limbs and function of shoulder joints were influenced slightly and reactivated soon.