电刀切割和机械切割在全胸腔镜肺段切除术段间平面分离中应用的对照研究

发布时间：2018-05-17 11:48

本文选题：胸腔镜 + 肺段切除术　；参考：《中国肺癌杂志》2017年01期

【摘要】：背景与目的全胸腔镜肺段切除术随早期肺癌的高检出率逐渐受到关注,其中肺段切除术段间平面分离最常用的方法是电刀切割手工缝合和应用直线切割缝合器机械切割两种。但仅有很少的研究对两者进行对比,且均针对开放式肺段切除术,目前尚未有相应的研究针对全胸腔镜肺段切除术。本研究旨在探讨两种方法在全胸腔镜手术中的应用及安全性对比。方法回顾性分析2013年9月-2016年3月北京大学第一医院胸外科行全胸腔镜肺段切除术的连续58例患者,根据段间平面分离方法不同分为电刀切割组30例和机械切割组28例,对两组患者手术时间、出血量、术后胸管留置时间、术后住院时间、胸腔引流量及术后并发症进行比较。结果除手术时间[电刀切割组(248.70±54.46)min和机械切割组(209.39±67.25)min]两组间有统计学差异(P=0.017)外,术中出血量(60.00mL vs 65.00 mL)、胸腔引流总量(445.00 mL vs 590.00 mL)、术后3天胸腔引流量[(455.33±318.333)mL vs(422.32±194.95)mL]、术后胸管留置时间(3.50天vs 4.00天)和术后住院时间(6.00天vs 6.00天)、术后并发症发生率(5/30vs 2/28),两组差异均无统计学意义。结论全胸腔镜肺段切除术段间平面的分离方法中,应用电刀切割手工缝合手术时间相对较长,但安全性不劣于应用切割缝合器机械切割缝合。
[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 卤54.46)min in the electrosurgical cutting group and 209.39 卤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 卤318.333)mL vs(422.32 卤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.
【作者单位】：北京大学第一医院胸外科;
【分类号】：R734.2

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