对比研究胸腔镜与剖胸手术诊治孤立性肺结节  

Thoracoscopy and thoracotomy for lung biopsy and wedge resection in solitary pulmonary nodule

作　　者：韦森[1] 孙克林[1] 张汝刚[1] 张德超[1] 程贵余[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤医院胸外科,北京100021

出　　处：《中国肺癌杂志》2004年第4期347-350,共4页Chinese Journal of Lung Cancer

摘　　要：目的　对比研究胸腔镜与剖胸手术楔形肺切除诊治孤立性肺结节的有效性及临床应用价值。方法　回顾性分析 73例临床诊断为孤立性肺结节且无明确病理诊断的患者 ,分别接受胸腔镜或剖胸手术行肺楔形切除。结果　两组的手术时间、术后恢复观察时间、胸腔闭式引流时间和引流量、术后止痛药物的用量、病变大小、活检准确性以及总住院时间、术后住院时间、住院费用等均无统计学差异 ,所有病例都获得病理确诊。结论　胸腔镜与剖胸手术对孤立性肺结节的诊断和病灶切除无显著性差别 ,两者都是可接受的手术方式。Objective Lung wedge resections and biopsies are frequently needed to diagnose and treat benign or malignant lung lesions. This study aims to compare thoracoscopy with thoracotomy for lung biopsy and wedge resection in solitary pulmonary nodule (SPN). Methods A controlled retrospective study was performed in this hospital. Patients with clinical diagnosis of SPN were undergone thoracoscopy or thoracotomy. Data of operation time, hours of stay in recover room, duration and volume of chest tube drainage, accuracy of biopsies, days of hospitalization and the whole cost of hospitalization were evaluated. Results All patients were received lung biopsies and wedge resections (thoracoscopy 26,thoracotomy 47), and they were diagnosed pathologically. The days of hospitalization were similar in the two groups. The minutes of operation had no significant difference (thoracoscopy: 103.9±29.4 minutes, thoracotomy: 94.7±33.9 minutes). Both groups had equivalent duration of chest tube drainage (thoracoscopy: 60.3±25.0 hours, thoracotomy: 62.5±20.1 hours, P =0.687) . The total volume of chest tube drainage showed no difference in both groups. The hours of stay in recover room (thoracoscopy: 75.4±21.6 hours, thoracotomy: 80.4±17.7 hours, P =0.287) and days of hospitalization after operation (thoracoscopy: 11.3±3.4 days, thoracotomy: 10.6±2.4 days, P = 0.304 ) were not different significantly. The whole cost of thoracoscopy was 17 800.2±6 038.9 CNY and thoracotomy was 17 677.4±6 327.8 CNY ( P = 0.936 ). Conclusion There is no significant difference in outcomes for thoracoscopy and thoracotomy approaches. Both thoracoscopy and thoracotomy are acceptable procedures for lung biopsy and wedge resection in solitary pulmonary nodules.

关 键 词：电视辅助胸腔镜外科 剖胸手术 肺结节病变 

分 类 号：R655.3[医药卫生—外科学]