CAJ | 학술논문

目的：探讨治疗各类孤立性肺结节（SPN）患者的最佳微创手术方式。方法：156例SPN患者被分为胸部小切口（ MST ）组89例和胸腔镜（ VATS ）组67例行手术，再根据病检和最后术式分为良性 MST 组、良性VATS组、恶性MST组、恶性VATS组。比较良性MST组和良性VATS组、恶性MST组和恶性VATS组之间在手术时间、出血量、术后住院时间、并发症发生率、住院费用、恶性患者淋巴结清扫数方面的差异。结果：原VATS组有7例中转为MST，中转率为10．44％。最后分为良性MST组25例、良性VATS组14例、恶性MST组71例、恶性VATS组46例。良、恶性MST组的手术时间和住院费用低于VATS组（P＜0．05），余差异无统计学意义（P＞0．05）。结论：在治疗SPN时，MST和VATS一样具有出血量少，恢复快，并发症少的优点。因此，对于VATS容易定位、既往无胸部疾病史且经济能承受的SPN 患者，推荐VATS诊治，反之， MST为首选。
목적：탐토치료각류고립성폐결절（SPN）환자적최가미창수술방식。방법：156례SPN환자피분위흉부소절구（ MST ）조89례화흉강경（ VATS ）조67례행수술，재근거병검화최후술식분위량성 MST 조、량성VATS조、악성MST조、악성VATS조。비교량성MST조화량성VATS조、악성MST조화악성VATS조지간재수술시간、출혈량、술후주원시간、병발증발생솔、주원비용、악성환자림파결청소수방면적차이。결과：원VATS조유7례중전위MST，중전솔위10．44％。최후분위량성MST조25례、량성VATS조14례、악성MST조71례、악성VATS조46례。량、악성MST조적수술시간화주원비용저우VATS조（P＜0．05），여차이무통계학의의（P＞0．05）。결론：재치료SPN시，MST화VATS일양구유출혈량소，회복쾌，병발증소적우점。인차，대우VATS용역정위、기왕무흉부질병사차경제능승수적SPN 환자，추천VATS진치，반지， MST위수선。
Objective To investigate the best surgical approach which will be minimally invasive for various types of patients with solitary pulmonary nodule (SPN). Methods One hundred and fifty-six SPN patients were divided into the MST (89 cases) and the VATS (67 cases) group. And then they were randomized into the benign MST group, the benign VATS group, the malignant MST group, and the malignant VATS group based on the pathological findings and final operation method. The related data, including operation time, blood loss during operation, length of hospital stay after surgery, the number of lymph nodes dissected form malignant SPN patient, cost of hospital stay, complications rate postoperative, situation of following-up of benign MST group and benign VATS group, malignant MST group and malignant VATS group were collected for analysis. Results Seven cases in the original VATS group were converted to the MST group, with the converting rate of 10.44%. The operation time and cost of hospitalization were lower in the MST group than those in the VATS group (P<0.05). Conclusion The MST and VATS possess some similar advantages, such as less bleeding, rapid recovery, and fewer complications. So, if the SPN can be located easily, the VATS should be recommended for the patients with no chest disease history, on the contrary, the MST is preferred.