Demmy Todd L, Plante Andrew J, Nwogu Chukwumere E, Takita Hiroshi, Anderson Timothy M
Department of Thoracic Surgery, Roswell Park Cancer Institute, Elm and Carlton St., Buffalo, NY 14263, USA.
Am J Surg. 2004 Dec;188(6):698-702. doi: 10.1016/j.amjsurg.2004.08.058.
The effects of video-assisted thoracic surgery (VATS) pulmonary lobectomy on after-hospital care are not well known.
In a retrospective case-control study, 20 consecutive VATS cases were matched to 38 standard thoracotomies (open cases).
Ages were 73.8 +/- 7.8 years with no initial differences between the groups. No hospital deaths occurred. Excluding 2 VATS and 6 open outliers, VATS cases had fewer hospital days (4.6 +/- 1.9 vs. 6.4 +/- 2.2, P <0.01), chest tube days (3.0 +/- 1.1 vs. 4.2 +/- 1.7, P = 0.01), and prolonged pain complaints (28% vs. 56%, P = 0.05). Transfer to care facilities or home nursing support was needed for 63% of open patients and only 20% of VATS patients (P = 0.015). Less personal care (10% vs. 21%), wound/medical care (0% vs. 13%), occupational/physical therapy (5% vs. 13%), or other home support (5% vs. 18%) was needed for VATS patients.
In older populations, more independence and fewer resources after discharge favor VATS lobectomy over standard thoracotomy.
电视辅助胸腔镜手术（VATS）肺叶切除术对出院后护理的影响尚不清楚。
在一项回顾性病例对照研究中，连续20例VATS病例与38例标准开胸手术（开放手术病例）进行匹配。
年龄为73.8±7.8岁，两组之间最初无差异。无医院死亡病例。排除2例VATS和6例开放手术异常值后，VATS病例的住院天数较少（4.6±1.9天对6.4±2.2天，P<0.01），胸管留置天数较少（3.0±1.1天对4.2±1.7天，P = 0.01），且疼痛持续抱怨较少（28%对56%，P = 0.05）。63%的开放手术患者需要转至护理机构或接受家庭护理支持，而VATS患者仅为20%（P = 0.015）。VATS患者需要的个人护理（10%对21%）、伤口/医疗护理（0%对13%）、职业/物理治疗（5%对13%）或其他家庭支持（5%对18%）较少。
在老年人群中，出院后更多的独立性和更少的资源需求使VATS肺叶切除术优于标准开胸手术。
