胸腔镜手术在中国地市级医院胸外科应用现状的问卷调查  

A Questionnaire Study Investigating Current Application Status of Video-assisted Thoracoscopic Surgery of Thoracic Surgeons in Some Municipal Hospitals in China

作　　者：杜恒[1] 廖虎[1] 宋志芳[1] 林琳[1] 马林[1] 车国卫[1] 刘伦旭[1] 

机构地区：[1]四川大学华西医院胸外科,成都610041

出　　处：《中国胸心血管外科临床杂志》2013年第3期347-351,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的研究中国地市级医院胸外科医师对胸腔镜手术的认识及应用现状,为今后胸腔镜手术的学习与培训提供参考。方法对参加2012年成都第五届华西微创胸外科手术论坛会议的地市级医院医师进行问卷调查。调查内容包括医师及医师所在医院胸外科的基本情况和胸腔镜手术应用情况等。共发放问卷263份,对收回的有效问卷183份(69.58%)进行描述性分析。结果 (1)对胸腔镜手术的看法:89.62%(164/183)的医师认为胸腔镜手术优点主要是创伤小且康复快,缺点是费用高(76.50%,140/183);71.04%(130/183)的医师认为肺癌患者行胸腔镜肺叶切除术后生活质量高,而仅有12.57%(23/183)认为5年生存率优于开胸手术;60.11%(110/183)的医师认为国内普及水平不如美国,但个别中心的水平优于或等同于美国;52.46%(96/183)认为胸腔镜手术可应用于局部晚期肺癌的治疗。(2)胸腔镜肺叶切除术学习情况:学习班或短期培训(32.24%,59/183)是胸腔镜肺叶切除术的最佳学习途径,开胸-小切口-腔镜(60.66%,111/183)是主要学习过程,而单向式(54.64%,100/183)是主要技术,其学习曲线是至少30例(26.78%,49/183);(3)胸腔镜应用情况:被调查医师所在的183家医院均开展胸腔镜手术,胸部良性疾病是最初开展(81.42%,149/183)的主要病种,肺癌肺叶切除术最初开展的困难是手术室及团队配合差(39.34%,72/183)和医师技术未成熟(36.07%,66/183);且胸腔镜技术的进一步优化(118/183,64.48%)是其发展方向。结论胸腔镜手术治疗胸部疾病(包括肺癌)已在中国大陆胸外科医师中达成共识,单向式是大家普遍采用的胸腔镜肺叶切除方法,胸腔镜培训和发展的方向是设备完善和建立团队。Objective To explore current view and application status of video-assisted thoracoscopic surgery （VATS） of thoracic surgeons in some municipal hospitals in China, and provide evidence for further VATS study and training. Methods We conducted a questionnaire study for thoracic surgeons in municipal hospitals who attended the 5th West China Forum on Mini-invasive Thoracic Surgery in 2012. The questionnaire content included general descriptions of the thoracic surgeons, the departments of thoracic surgery where they worked, and VATS application status in their hospitals. A total of 263 surgeons were investigated, and 183 （69.58%）valid questionnaires were collected for descriptive analysis. Results （ 1 ） Responders＇ view of VATS： There were 89.62% （ 164/183 ） responders who believed that the advantages of VATS were mainly mini-invasive and fast postoperative recovery, while its disadvantage was high cost （76.50%, 140/183 ）. There were 71.04% （ 130/183 ） responders who thought that VATS lobectomy could provide a higher postoperative quality of life for lung cancer patients, while only 12.57% （23/183） responders thought that the 5-year survival rate of VATS was higher than that of open thoracotomy. There were 60.11% （ 110/183 ） responders who believed that VATS was less widely performed in China than America, but VATS level of very few hospitals in China was superior or equal to American level. There were 52.46% （96/183 ） responders who agreed that VATS could be used for the treatment of locally advanced lung cancer. （2） Training situation of VATS lobectomy for lung cancer： Learning class or short-term training（32.24%, 59/183 ） was the best way to learn VATS lobectomy. Their main learning process was from open thoracotomy to mini- thoracotomy then to VATS （60.66%, 111/183）. Single-direction thoracoscopic lobectomy was the most popular VATS technique （54.64%, 100/183 ）, and its learning curve was at least 30 cases （26.78%, 49/183 ）. （ 3 ） VATS application

关 键 词：胸腔镜手术 胸部疾病 调查报告 

分 类 号：R655.3[医药卫生—外科学]