Wan Innes Y P, Thung Kin Hoi, Hsin Michael K Y, Underwood Malcolm J, Yim Anthony P C
Division of Cardiothoracic Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
Ann Thorac Surg. 2008 Feb;85(2):416-9. doi: 10.1016/j.athoracsur.2007.10.009.
Video-assisted thoracoscopic surgery (VATS) major lung resection for lung cancer has been an important part of thoracic surgical training program in our institution. In this study, we compared the results of VATS major lung resection performed by surgical trainees with those performed by experienced thoracic surgeons with specialist interest in VATS.
From January 2002 to October 2006, the clinical data of 111 consecutive patients scheduled for VATS major lung resection were prospectively entered into the computerized clinical management system of the local health authority; these include patient demographics, comorbidity, operating time, postoperative complications, and outcome. We retrospectively compared the data of patients who were operated on by trainees with those who were operated on by experienced VATS surgeons.
One hundred and eleven patients with clinical stage I and II lung cancer underwent VATS major lung resection. Fifty-one (46%) of the procedures were performed by consultant surgeons and 60 VATS lung resections (54%) were performed by supervised trainees. Patients' demography and risk factors were comparable between the two groups. Trainees spent more time in performing the operation as compared with experienced VATS surgeons (mean operating time 162 minutes, p = 0.01). There was no significant difference in intraoperative or postoperative complications and outcomes between the two groups.
Video-assisted thoracic surgery major lung resection for early stage nonsmall-cell lung cancer can be taught to residents who work under the supervision of experienced VATS surgeons. Video-assisted thoracic surgery major lung resection for lung cancer should be an integral part of thoracic surgical training program.
电视辅助胸腔镜手术（VATS）下肺癌肺叶切除术一直是我院胸外科培训项目的重要组成部分。在本研究中，我们比较了外科实习生与对VATS有专业兴趣的经验丰富胸外科医生进行VATS肺叶切除术的结果。
2002年1月至2006年10月，连续111例计划行VATS肺叶切除术患者的临床资料前瞻性录入当地卫生部门的计算机化临床管理系统；这些资料包括患者人口统计学信息、合并症、手术时间、术后并发症及预后。我们回顾性比较了实习生手术患者与经验丰富的VATS外科医生手术患者的数据。
111例临床I期和II期肺癌患者接受了VATS肺叶切除术。其中51例（46%）手术由顾问外科医生完成，60例VATS肺叶切除术（54%）由带教实习生完成。两组患者的人口统计学信息和危险因素具有可比性。与经验丰富的VATS外科医生相比，实习生手术时间更长（平均手术时间162分钟，p = 0.01）。两组患者术中及术后并发症和预后无显著差异。
在经验丰富的VATS外科医生指导下，可向住院医师传授电视辅助胸腔镜手术下早期非小细胞肺癌肺叶切除术。电视辅助胸腔镜手术下肺癌肺叶切除术应成为胸外科培训项目的一个组成部分。
