CAJ | 학술논문

目的：探讨电视胸腔镜（ VATS）单操作孔方法行肺大疱切除术治疗气胸的可行性。方法胸腔镜肺大疱切除＋胸膜摩擦固定术患者327例，分成单操作孔治疗组194例和传统双操作孔法对照组133例，对比两组手术时间、术后胸腔引流量、术后漏气时间、术后拔管时间、术后复发情况、术中钉仓使用量。结果两组手术时间、出血量、术后复发率及术后住院时间、术中使用钉仓数量比较，差异均无统计学意义（P＞0．05）；与双操作孔组比较，单操作孔组术后伤口疼痛、麻木均有显著改善（P＜0．05）。结论单操作孔治疗法与传统双操作孔法VATS肺大疱切除术治疗自发性气胸疗效相当，但单操作孔术后患者疼痛更轻、麻木感出现较少。
목적：탐토전시흉강경（ VATS）단조작공방법행폐대포절제술치료기흉적가행성。방법흉강경폐대포절제＋흉막마찰고정술환자327례，분성단조작공치료조194례화전통쌍조작공법대조조133례，대비량조수술시간、술후흉강인류량、술후루기시간、술후발관시간、술후복발정황、술중정창사용량。결과량조수술시간、출혈량、술후복발솔급술후주원시간、술중사용정창수량비교，차이균무통계학의의（P＞0．05）；여쌍조작공조비교，단조작공조술후상구동통、마목균유현저개선（P＜0．05）。결론단조작공치요법여전통쌍조작공법VATS폐대포절제술치료자발성기흉료효상당，단단조작공술후환자동통경경、마목감출현교소。
Objective To discuss the feasibility of uniportal video-assisted thoracic surgery ( VATS) technique applied to pulmonary bullae resection for the treatment of spontaneous pneumothorax .Methods Three hundred and twenty-seven cases undergoing video-assisted pulmonary bullae resction and pleurodesis were divided into uniportal VATS technique group ( n=194) and traditional two-port VATS technique group ( n=133) .The clinical data including the operation time , postoperative thoracic cavity drainage volume , postoperative leakage time , postoperative extubation time,postoperative recurrence rate and perioperative staple-using number were compared between two groups .Results There were no significant differences in operation time ,bleeding ,postoperative recurrence ,postoperative hospital stay and perioperative staple-using number between two groups (P>0.05).The postoperative pain and wound numbness in the uniportal VATS technique group improved significantly compared with two -port VATS technique group ( P <0.05 ) . Conclusion The uniportal VATS technique has similar effect with two-port VATS technique on spontaneous pneumothorax patients undergoing pulmonary bullae resction ,but the patients using the uniportal technique have less pains and wound numbness after operation .