CAJ | 학술논문

目的总结电视辅助胸腔镜外科(VATS)在胸部肿瘤外科的适应证和安全性.方法回顾分析中国医学科学院肿瘤医院胸外科2009年1-11月连续144例胸部肿瘤住院病人VATS病例资料.结果全组无中转开胸病例.术后合并症发生率2.08%(3/144),病死率0.69%(1/144).VATS肺叶切除与常规开胸肺叶切除两组的手术时间、术中淋巴结清扫数量、术后并发症发生率、院内病死率、总住院时间和术后住院时间无明显差别,而VATS组胸管留置时间少于常规开胸组,VATS组早期病例更多.VATS肺楔形切除与常规开胸肺楔形切除术两组的胸管留置时间、术后并发症、院内病死率和术后住院时间无明显差别,而VATS组手术时间和总住院时间均少于常规开胸组.结论 VATS的并发症发生率和病死率是可以接受的.VATS肺叶切除术可以作为早期肺癌外科治疗的一种方案.对于肺楔形切除术,VATS优于常规开胸.
목적 총결전시보조흉강경외과(VATS)재흉부종류외과적괄응증화안전성.방법 회고분석중국의학과학원종류의원흉외과2009년1-11월련속144례흉부종류주원병인VATS병례자료.결과 전조무중전개흉병례.술후합병증발생솔2.08%(3/144),병사솔0.69%(1/144).VATS폐협절제여상규개흉폐협절제량조적수술시간、술중림파결청소수량、술후병발증발생솔、원내병사솔、총주원시간화술후주원시간무명현차별,이VATS조흉관류치시간소우상규개흉조,VATS조조기병례경다.VATS폐설형절제여상규개흉폐설형절제술량조적흉관류치시간、술후병발증、원내병사솔화술후주원시간무명현차별,이VATS조수술시간화총주원시간균소우상규개흉조.결론 VATS적병발증발생솔화병사솔시가이접수적.VATS폐협절제술가이작위조기폐암외과치료적일충방안.대우폐설형절제술,VATS우우상규개흉.
Objective To evaluate the indication and safety of video assisted thoracic surgery (VATS) for chest tumors. Methods Data of 144 consecutive patients receiving VATS between January and November 2009 in Cancer hospital Chinese Academy of Medical Sciences were retrospectively reviewed.Results There was no conversion to open thoracotomy. Overall morbidity rate was 2. 08% (3/144) and mortality rate was 0. 69% (1/144). There were no significant differences for operative time, number of nodal dissection, morbidity rate, mortality rate, overall hospitalization and postoperative length of stay between VATS lobectomy group and open thoracotomy (OT) lobectomy group. Chest tube duration was shorter in the VATS lobectomy group than OT lobectomy group and more early-stage lung cancer patients were found in VATS group. There were no significant differences for number of nodal dissection, chest tube duration, morbidity rate, mortality rate, and postoperative length of stay between VATS lung wedge resection group and OT lung wedge resection group. Operative time and overall hospitalization were shorter in the VATS wedge resection group than OT wedge resection group. Conclusion Morbidity and mortality rate of VATS were acceptable. VATS lobectomy can be used as an alternative surgical technique for early-stage lung cancer. For lung wedge resection, VATS was superior than OT.