三种胸腔镜下肺叶切除术的手术方法及结果比较  

Comparison of method and result of three types of thoracoscopic lobectomy

作　　者：杨博[1] 初向阳[1] 戴为民[1] 孙玉鹗[1] 刘阳[1] 王钰琦[1] 汪涛[1] 赵明[1] 

机构地区：[1]解放军总医院胸外科,北京100853

出　　处：《解放军医学杂志》2013年第11期913-916,共4页Medical Journal of Chinese People's Liberation Army

摘　　要：目的比较胸腔镜辅助肺叶切除术、全胸腔镜肺叶切除术、单操作孔肺叶切除术的手术方法及效果,为手术方式的选择提供借鉴。方法收集2007年5月-2012年5月在解放军总医院行胸腔镜下肺叶切除术的374例患者的临床资料,并进行回顾性分析。结果 374例患者按照手术方法不同分为3组。A组行胸腔镜辅助肺叶切除术,共完成40例;B组行全胸腔镜肺叶切除术,共完成280例;C组为单操作孔肺叶切除术,共完成54例。3组患者的一般情况差异无统计学意义。A组的手术时间(180.4±43.5min)长于B组和C组(分别为153.2±28.6、162.5±32.3min,P<0.05),B、C组的手术时间差异无统计学意义。术中出血量、中转开胸率、术后并发症发生率、术后拔管、出院时间及淋巴结清扫结果3组比较差异无统计学意义。结论三种胸腔镜下肺叶切除术的结果无明显差异。术者可根据自身的手术熟练程度及手术难度选择不同的手术方法。Objective To compare the method and result of thoracoscope-assisted lobectomy, thoracoscopic lobectomy and singlelport laparoscopic lobectomy, and provide a reference for choice of surgical method. Methods Clinic data of 374 patients undergone thoracoscopic lobectomy from May 2007 to May 2012 in General Hospital of PLA were retrospectively analyzed. Results Three hundred and seventy-four patients were classified into 3 groups according to different surgical method. Group A included 40 patients who underwent video-assisted lobectomy, group B consisted of 280 patients who received thoracoscopic lobectomy, and group C consisted of 54 patients who underwent single-port laparoscopic lobectomy. The general data were similar among the 3 groups. The operative time was longer in group A （180.4 ± 43.5min） than in groups B and C （153.2 ± 28.6, 162.5± 32.3min, P〈0.05）, but it was similar between groups B and C. There was no significant differences in blood loss, incidence of conversion to thoracotomy, postoperative complications, chest tube removal time, postoperative discharge time, lymph node dissection result among 3 groups. Conclusions Three types of thoracoscopic lobectomy showed similar results. The option of the method depends on degree of operative difficulty and surgeon＇s proficiency in performing the operation.

关 键 词：胸外科手术 电视辅助 肺叶切除术 治疗结果 

分 类 号：R655.3[医药卫生—外科学]