Billè Andrea, Okiror Lawrence, Karenovics Wolfram, Choudhuri Debajeet, Routledge Tom
Department of Thoracic Surgery, Guy's and St Thomas Hospital, Great Maze Pond, London SE1 9RT, UK.
Gen Thorac Cardiovasc Surg. 2013 Jul;61(7):409-13. doi: 10.1007/s11748-013-0225-5. Epub 2013 Mar 1.
To evaluate the feasibility of training program in video assisted thoracic surgery (VATS) lobectomy comparing intraoperative and postoperative data of patients operated on by an established consultant and trainees.
Retrospective analysis of 100 consecutive patients who underwent VATS lobectomies between May 2008 and May 2012. 66 patients were operated on by an established consultant (Group A) and 34 by trainees (Group B).
The groups were comparable for clinical characteristics and pathological staging. The mean operating time in Group A was 125 ± 30 min and in Group B was 133 ± 26 min (p = 0.18). The rate of conversion was similar in both groups: 9.1% in Group A and 8.8% in Group B (p = 0.6). The complication rate was comparable (p = 0.4): 36.3% in Group A and 32.3% in Group B. Median time to drain removal and median length of hospital stay was 3 and 5.5 days in Group A and 3 and 5 days in Group B, showing no statistical differences between the two groups (p = 0.3 and 0.5). There were no differences in term of long-term complications between the two groups.
Our study showed that a training program in VATS lobectomy is feasible, without increasing the operative time, conversion rate, postoperative complication, time to drain removal, and length of hospital stay.
通过比较由经验丰富的会诊医生和受训人员实施手术的患者的术中及术后数据，评估电视辅助胸腔镜手术（VATS）肺叶切除术培训项目的可行性。
对2008年5月至2012年5月期间连续接受VATS肺叶切除术的100例患者进行回顾性分析。66例患者由经验丰富的会诊医生实施手术（A组），34例由受训人员实施手术（B组）。
两组患者的临床特征和病理分期具有可比性。A组平均手术时间为125±30分钟，B组为133±26分钟（p = 0.18）。两组的中转率相似：A组为9.1%，B组为8.8%（p = 0.6）。并发症发生率相当（p = 0.4）：A组为36.3%，B组为32.3%。A组拔除引流管的中位时间和住院时间中位数分别为3天和5.5天，B组为3天和5天，两组间无统计学差异（p = 0.3和0.5）。两组在长期并发症方面无差异。
我们的研究表明，VATS肺叶切除术培训项目是可行的，不会增加手术时间、中转率、术后并发症、拔除引流管时间和住院时间。
