摘要
目的探讨经剑突下胸腔镜手术(S-VATS)治疗前纵隔肿瘤的安全性、有效性,以及影响手术疗效的危险因素。方法收集2014年6月—2016年6月在福建医科大学附属协和医院胸外科住院的87例前纵隔肿瘤患者的临床资料,根据手术方式分为I-VATS组(n=40)和S-VATS组(n=47),比较两组患者的手术时间、术中出血量以及术后置管时间、引流量、镇痛药使用时间、住院费用和术后住院时间的差异。结果两组患者均顺利完成手术,无中转开胸病例,术后顺利出院,随访期间无死亡病例。S-VATS组术后置管时间、胸腔引流量、镇痛药物使用时间均明显少于I-VATS组,差异有统计学意义[(2.4±0.1)d vs(2.9±0.2)d,P<0.05;(203.1±29.9)ml vs(462.9±54.1)ml,P<0.01;(0.9±0.2)d vs(2.5±0.3)d,P<0.01];S-VATS组手术时间、术中出血量及术后住院费用略高于I-VATS组,但差异均无统计学意义(P>0.05)。术后随访10~24月,S-VATS组无局部复发。结论 S-VATS治疗前纵隔肿瘤创伤小、术后疼痛轻、术后引流量少,住院费用、术后住院时间及疗效与I-VATS无明显差别,是前纵隔肿瘤的重要治疗方法。
Objective To discuss the security, effectiveness and risk factors of video assisted thoracoscopic surgery with subxyphoid approach in treatment of anterior mediastinal tumor.MethodsThe clinical data of 87 patients with anterior mediastinal cancer who were hospitalized in Department of Thoracic Surgery, Union Clinical Medical College of Fujian Medical University from June 2014 to June 2016 were collected and divided into I VATS group （n = 40） and S VATS （n= 47）. The differences of operation time, intraoperative blood loss, postoperative catheterization time, drainage volume, analgesic use time, hospitalization cost and postoperative hospital stay were compared.ResultsThe two groups’ surgeries were successful, no transfer of thoracotomy cases, no deaths during follow up. The time of catheterization, drainage of thoracic cavity and the time of using analgesic drugs in S VATS group were significantly less than those in I VATS group [（2.4 ± 0.1） d vs （2.9 ± 0.2） d, P〈 0.05]; （203.1 ± 29.9） ml vs （462.9 ± 54.1） ml, P 〈0.01; （0.9 ± 0.2） d vs （2.5 ±0.3） d, P〈0.01] And postoperative hospitalization costs were slightly higher than the I VATS group, but the difference was not statistically significant （P〉0.05）. All cases were followed up for 10 24 months. There was no local recurrence in S VATS group.
ConclusionsThe video assisted thoracoscopic surgery with subxyphoid approach for the treatment of anterior mediastinal tumor is safe and feasible.It is reliable minimally invasive,light pain and safety.It is an important and advanced treatment.
出处
《中华胸部外科电子杂志》
2018年第1期16-21,共6页
CHINESE JOURNAL OF THORACIC SURGERY：Electronic Edition
关键词
经剑突下
经肋间
胸腔镜手术
前纵隔肿瘤
Subxyphoid approach
Intercostal approach
Video assisted thoracoscopic surgery
Anterior mediastinal tumor
作者简介
通信作者：康明强,Email：kangmingqiangsina.com
