微创肺叶切除术的临床研究

Dan-qing Fang, Pin-xian Peng, Cheng-quan Liao
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引用次数: 0

摘要

目的:探讨胸椎小切口在肺叶切除术中的应用,其效果与常规切口相当。方法:386例肺肿瘤患者随机分为胸小切口组(n=184;平均切口长度12.7 cm)和标准胸切口组(对照组,n=152)。比较两组患者的切口长度、手术时间、术中出血量、术后引流量、输血量、止血药量、下床时间、住院时间及主要并发症。结果:小切口组各指标均明显优于对照组(P0.05)。小切口组无严重并发症发生,4例因粘连或肿瘤巨大而改行常规开胸。结论:保留肌肉的胸椎小切口具有侵入性小、出血量少、疼痛少、住院时间短、并发症少、术后美观等优点,临床效果良好。该手术符合肺叶切除的要求,为常规肺叶切除肺肿瘤提供了一种选择。
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[A clinical study of lobectomy with minimally invasive incision].

Objective: To study the application of small thoracic incision for lobectomy with effects comparable to that of conventional incision.

Methods: A total of 386 patients with lung tumors were prospectively randomized into thoracic small incision group (n=184; average length of incision, 12.7 cm) and standard thoracic incision group (control group, n=152). The incision length, operation time, intra-operative bleeding volume, postoperative drainage volume, transfusion, hemostatic dosage, ambulation time, hospital stay and major complications were compared between the two groups.

Results: All of the indices in small incision group were significantly better than those of the control group (P<0.01) except the operation time (P>0.05). No severe complications occurred in small incision group, and in 4 cases conventional thoracotomy was performed instead due to adhesion or giant tumors.

Conclusions: Muscle-sparing thoracic small incision can achieve excellent clinical result and has such advantages as less invasiveness, reduced bleeding volume, pain and hospital stay, less complications, and better postoperative appearance. This procedure meets the requirements of lobectomy and provides an alternative for routine lobectomy for pulmonary tumors.

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