本文選題：胸腔鏡 + 肺段切除術(shù)��； 參考：《中國(guó)肺癌雜志》2017年01期

【摘要】：背景與目的全胸腔鏡肺段切除術(shù)隨早期肺癌的高檢出率逐漸受到關(guān)注,其中肺段切除術(shù)段間平面分離最常用的方法是電刀切割手工縫合和應(yīng)用直線切割縫合器機(jī)械切割兩種。但僅有很少的研究對(duì)兩者進(jìn)行對(duì)比,且均針對(duì)開(kāi)放式肺段切除術(shù),目前尚未有相應(yīng)的研究針對(duì)全胸腔鏡肺段切除術(shù)。本研究旨在探討兩種方法在全胸腔鏡手術(shù)中的應(yīng)用及安全性對(duì)比。方法回顧性分析2013年9月-2016年3月北京大學(xué)第一醫(yī)院胸外科行全胸腔鏡肺段切除術(shù)的連續(xù)58例患者,根據(jù)段間平面分離方法不同分為電刀切割組30例和機(jī)械切割組28例,對(duì)兩組患者手術(shù)時(shí)間、出血量、術(shù)后胸管留置時(shí)間、術(shù)后住院時(shí)間、胸腔引流量及術(shù)后并發(fā)癥進(jìn)行比較。結(jié)果除手術(shù)時(shí)間[電刀切割組(248.70±54.46)min和機(jī)械切割組(209.39±67.25)min]兩組間有統(tǒng)計(jì)學(xué)差異(P=0.017)外,術(shù)中出血量(60.00mL vs 65.00 mL)、胸腔引流總量(445.00 mL vs 590.00 mL)、術(shù)后3天胸腔引流量[(455.33±318.333)mL vs(422.32±194.95)mL]、術(shù)后胸管留置時(shí)間(3.50天vs 4.00天)和術(shù)后住院時(shí)間(6.00天vs 6.00天)、術(shù)后并發(fā)癥發(fā)生率(5/30vs 2/28),兩組差異均無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論全胸腔鏡肺段切除術(shù)段間平面的分離方法中,應(yīng)用電刀切割手工縫合手術(shù)時(shí)間相對(duì)較長(zhǎng),但安全性不劣于應(yīng)用切割縫合器機(jī)械切割縫合。
[Abstract]:Background and objective Total thoracoscopic pneumonectomy with high detection rate of early lung cancer has been paid more and more attention. The most commonly used methods of segmental plane separation in segmental resection of lung are electric knife cutting manual suture and mechanical cutting with linear cutting and suture device. However, only a few studies have compared the two, and both of them are open segmental resection, so far, there is no corresponding research on total thoracoscopic pneumonectomy. The purpose of this study was to explore the application and safety of two methods in total thoracoscopic surgery. Methods from September 2013 to March 2016, 58 consecutive patients undergoing total thoracoscopic pneumonectomy in the Department of Thoracic surgery, first Hospital of Peking University, were retrospectively analyzed. According to the different methods of intersegmental plane separation, the patients were divided into two groups: electrosurgical cutting group (n = 30) and mechanical cutting group (n = 28). The operative time, bleeding volume, postoperative chest tube retention time, postoperative hospitalization time, thoracic drainage volume and postoperative complications were compared between the two groups. Results except for the operation time (248.70 鹵54.46)min in the electrosurgical cutting group and 209.39 鹵67.25)min in the mechanical cutting group), there was a significant difference between the two groups (P < 0.017). The intraoperative bleeding volume was 60.00mL vs 65.00 mL / L, the total volume of thoracic drainage was 445.00 mL vs 590.00 mL / L, the thoracic drainage volume was 455.33 鹵318.333)mL vs(422.32 鹵194.95)mL 3 days after operation, and the time of postoperative chest tube indwelling was 3.50 days vs 4.00 days), and the postoperative hospitalization time was 6.00 days vs 6.00 days. The incidence of postoperative complications was 5 / 30 vs 2 / 28. The difference was not statistically significant. Conclusion in the method of separating the intersegmental plane of total thoracoscopic pneumonectomy, the time of manual suture by electric knife is relatively long, but the safety is not inferior to that of mechanical suture by cutting suture.
【作者單位】： 北京大學(xué)第一醫(yī)院胸外科;
【分類號(hào)】：R734.2

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