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肺段切除术后的并发症及呼吸功能——肺段间平面制作方法的比较

Postoperative complications and respiratory function following segmentectomy of the lung - comparison of the methods of making an inter-segmental plane.

作者信息

Miyasaka Yoshikazu, Oh Shiaki, Takahashi Nobumasa, Takamochi Kazuya, Suzuki Kenji

机构信息

Division of General Thoracic Surgery, Juntendo University School of Medicine, 1-3 Hongo 3-chome, Bunkyo-ku, Tokyo 113-8431, Japan.

出版信息

Interact Cardiovasc Thorac Surg. 2011 Mar;12(3):426-9. doi: 10.1510/icvts.2010.253989. Epub 2010 Nov 16.

Abstract

Segmentectomy could be one of the standard modes of surgery for the treatment of early lung cancer. However, segmentectomy could be more difficult than lobectomy as to the management of inter-segmental plane. The relationship between methods of dividing an inter-segmental plane and postoperative complication/pulmonary function was investigated in this study. A retrospective study was conducted on 49 patients who underwent segmentectomy of the lung between February 2008 and April 2009 at our institute. Eighteen (36.7%) were male and 31 (63.3%) were female. The inter-segmental plane was divided with only a mechanical stapler in 18 patients, and electrocautery was used in the other 31 patients. There were no significant relationships between clinicopathological features and both procedures, except gender, operative time, and pleurodesis (P<0.05). Preserved forced expiratory volume in one second (FEV(1)) was not affected by the procedures. Patients who underwent left upper division segmentectomy had significantly more complications. On multivariate analysis, resected segment and intraoperative blood loss were found to be significant predictors for postoperative complications. There were no significant relationships between the methods of making inter-segmental planes and postoperative complications and/or lung functions. Resected segment and intraoperative blood loss were predictors for postoperative complication in segmental resection of the lung.

摘要

肺段切除术可能是早期肺癌治疗的标准手术方式之一。然而,在肺段间平面的处理上,肺段切除术可能比肺叶切除术更具难度。本研究探讨了划分肺段间平面的方法与术后并发症/肺功能之间的关系。对2008年2月至2009年4月在我院接受肺段切除术的49例患者进行了回顾性研究。其中男性18例(36.7%),女性31例(63.3%)。18例患者仅用机械吻合器划分肺段间平面,另外31例患者使用了电灼法。除性别、手术时间和胸膜固定术外,临床病理特征与两种手术方式之间均无显著相关性(P<0.05)。一秒用力呼气容积(FEV(1))的保留不受手术方式的影响。接受左上叶段切除术的患者并发症明显更多。多因素分析发现,切除的肺段和术中失血是术后并发症的重要预测因素。划分肺段间平面的方法与术后并发症和/或肺功能之间无显著相关性。切除的肺段和术中失血是肺段切除术术后并发症的预测因素。

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