混合现实技术引导电视辅助胸腔镜解剖性肺段切除术治疗肺结节的围术期效果  

Perioperative effect of thoracoscopic anatomical segmentectomy guided by mixed reality technology-guided video-assisted thoracic surgery in the treatment of pulmonary nodules

作　　者：李超 洪海宁 臧超 戈巧 杨逸凡 桑海威 王安生 Li Chao;Hong Haining;Zang Chao;Ge Qiao;Yang Yifan;Sang Haiwei;Wang Ansheng(Department of Thoracic,the First Affiliated Hospital of Bengbu Medical University,Bengbu 233004,China;Graduate School of Bengbu Medical University,Bengbu 233030,China)

机构地区：[1]蚌埠医科大学第一附属医院胸外科,蚌埠233004 [2]蚌埠医科大学研究生院,蚌埠233030

出　　处：《中华解剖与临床杂志》2024年第12期816-822,共7页Chinese Journal of Anatomy and Clinics

基　　金：安徽省教育厅重点项目(2022AH051513)。

摘　　要：目的探讨混合现实技术引导电视辅助胸腔镜解剖性肺段切除术治疗肺结节的围术期效果。方法回顾性队列研究。纳入2022年6月—2022年12月蚌埠医科大学第一附属医院行解剖性肺段切除术治疗的74例肺部结节患者的临床资料,其中男26例、女48例,年龄34~72(57.3±8.3)岁。根据患者手术方式的不同分为2组:采用混合现实技术引导电视辅助胸腔镜手术31例为观察组,采用传统电视辅助胸腔镜手术43例为对照组。比较2组患者手术时间、术中出血量、手术前后血红蛋白变化量、淋巴结清扫或采样站数及数量、24 h胸腔引流管引流量、胸腔引流管留置时间、术后住院时间、并发症发生情况等。结果74例患者均顺利完成手术,无中转开胸手术,离体标本切缘均为阴性。病变病理类型包括炎性病变8例、非典型增生3例、硬化性肺细胞癌1例、原位腺癌15例、微浸润性腺癌16例、腺癌29例、鳞癌1例、小细胞癌1例,其中肿瘤患者术后临床病理分期均在Ⅰ期内。2组患者的性别、年龄、吸烟史、饮酒史、高血压病史、糖尿病病史、心脑血管病史、体质量指数、术前第一秒用力呼气容积、术前每分钟最大通气量、术前血清白蛋白等基线资料比较,差异均无统计学意义(P值均>0.05)。观察组与对照组的术中出血量分别为50(50,50)和80(50,100)mL,胸腔引流管留置时间分别为3(3,4)和4(4,5)d,淋巴结清扫或采样数量分别为(7.29±4.68)和(4.81±2.76)枚,2组比较差异均有统计学意义(Z=-4.35、-2.88,t=2.85,P值均<0.05);2组患者的手术时间、术前术后血红蛋白变化量、24 h胸腔引流量、淋巴结清扫或采样站数、术后并发症总发生率差异均无统计学意义(P值均>0.05)。结论混合现实技术引导电视辅助胸腔镜解剖性肺段切除术治疗肺结节安全可行,其围术期效果与传统电视辅助胸腔镜解剖性肺段切除术相当,但术中失血量、清Objective This study aimed to explore the perioperative effect of mixed reality technology-guided video-assisted thoracic surgery(VATS)in the treatment of pulmonary nodules.Methods In this retrospective cohort study,clinical data were collected from 74 patients with pulmonary nodules who underwent segmentectomy at the First Affiliated Hospital of Bengbu Medical University from June 2022 to December 2022,including 26 males and 48 females aged 34-72(57.3±8.3)years.In accordance with different surgical methods,patients were divided into two groups:31 cases using mixed reality surgery as the observation group and 43 cases using traditional thoracoscopic surgery as the control group.The perioperative indicators of the two groups were compared,including operation time,intraoperative blood loss,changes in hemoglobin levels before and after surgery,the number of lymph node dissections or samples,the number of lymph nodes dissected or sampled,24 h chest tube drainage,chest tube retention time,postoperative hospital stay,and complications.Results The surgery was successfully conducted in 74 patients without conversion to thoracotomy,and all tracheal margins were negative.Postoperative clinical pathological staging was within stageⅠ,with specific pathological types,including eight cases of inflammatory lesions,three cases of atypical hyperplasia,one case of sclerosing pneumocytoma,15 cases of adenocarcinoma in situ,16 cases of minimally invasive adenocarcinoma,29 cases of adenocarcinoma,one case of squamous cell carcinoma,and one case of small cell carcinoma.No statistically significant differences were observed between the two groups in terms of baseline data such as gender,age,smoking history,drinking history,history of hypertension,history of diabetes,history of cardiovascular and cerebrovascular diseases,body mass index,preoperative forced expiratory volume in 1 s,preoperative maximum minute ventilation,and preoperative serum albumin(all P values>0.05).The intraoperative blood losses in the observation and control gr

关 键 词：肺结节 混合现实技术 胸腔镜外科手术 解剖性 肺段切除术 

分 类 号：R655.3[医药卫生—外科学]