CAJ | 학술논문

目的：与传统开胸术相比，2切口胸腔镜最大程度地减轻了患者的疼痛，然而在世界范围内对其报道却较少，多因2个切口难以完成复杂的手术操作，并对其术中安全性产生质疑。我们比较开胸术与2切口胸腔镜对临床早期可切除的肺癌病人行肺癌根治术的安全性。方法于2009年2月-2011年12月，共对临床早期肺癌行开胸手术334例，2切口完全胸腔镜手术66例，17例患者中转开胸，我们对手术时间，术前术后及总住院天数，术后拔管时间，术后并发症进行比较分析。结果开胸与胸腔镜手术在手术时间上左肺下叶两者手术时间分别为162．5±6．5及185．8±12．8分钟（P＝0．1228），两者比较无统计学差异，其余肺叶手术时间2切口胸腔镜长于开胸手术，开胸与胸腔镜手术后总的并发症发生率分别为10．2％和15．0％（P＝0．238），两者比较无统计学差异，围手术期死亡率分别为2．0％及0．0％（P＝1．000），两者比较无统计学差异。结论2切口胸腔镜手术对临床早期肺癌行肺癌根治术是安全可行的。
목적：여전통개흉술상비，2절구흉강경최대정도지감경료환자적동통，연이재세계범위내대기보도각교소，다인2개절구난이완성복잡적수술조작，병대기술중안전성산생질의。아문비교개흉술여2절구흉강경대림상조기가절제적폐암병인행폐암근치술적안전성。방법우2009년2월-2011년12월，공대림상조기폐암행개흉수술334례，2절구완전흉강경수술66례，17례환자중전개흉，아문대수술시간，술전술후급총주원천수，술후발관시간，술후병발증진행비교분석。결과개흉여흉강경수술재수술시간상좌폐하협량자수술시간분별위162．5±6．5급185．8±12．8분종（P＝0．1228），량자비교무통계학차이，기여폐협수술시간2절구흉강경장우개흉수술，개흉여흉강경수술후총적병발증발생솔분별위10．2％화15．0％（P＝0．238），량자비교무통계학차이，위수술기사망솔분별위2．0％급0．0％（P＝1．000），량자비교무통계학차이。결론2절구흉강경수술대림상조기폐암행폐암근치술시안전가행적。
Objective Two-incision video-assisted thoracic surger relieved post operative pain when compared with open thoractomy ,while it is rarely reported worldwide ,most thoracic surgeons think it is hard to finish the complicated operation and it is not safe .We compared the safety between open and two -incision VATS.Methods Bwteen Febrary 2009 to December 2011 ,a total of 334 cases with clinical early -staged lung cancer of open thoracotomy were performed ,66 cases were completely performed with 2-incision VATS,17 cases were transferred to open thoracotomy defined as two -incision VATS assisted thoracotomy .We compared and ana-lyzed open thoracotomy with two -incision VATS in operating time ,and pre,post and total period of hospitaliza-tion,postoperative chest tube removal time ,postoperative complications .Results Operating time in the left lower lobe of both traditional open thoracotomy and two -incision VATS was 162.5 ±6.5 and 185.8 ±12.8 minutes re-spectively(P=0.1228),there was no statistical significance for the remaining parts of the lobectomy ,the operat-ing time of open thoracotomy was shorter than two -incision VATS.The overall complication and perioperative mortality rate of open thoracotomy and two -incision VATS were 10.2% and 15.0%(P=0.238),and 2.0%and 0.0%(P=1.000)respectively,there was no statistical significance.Conclusion The lobectomy and lymph node dissections for 2-incision VATS in treating clinical stage I lung cancer is feasible and safe .