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电视辅助胸腔镜手术对于需要进行肺叶切除术的良性肺部疾病来说是一种安全的选择。

Video-assisted thoracoscopic surgery is a safe option for benign lung diseases requiring lobectomy.

作者信息

Mazzella Antonio, Olland Anne, Garelli Elena, Renaud Stephane, Reeb Jeremie, Santelmo Nicola, Falcoz Pierre Emmanuel, Massard Gilbert

机构信息

Department of thoracic surgery, Hôpitaux universitaires de Strasbourg, Nouvel Hôpital Civil, 1 Place de l'Hôpital, BP 426, 67091, Strasbourg Cedex, France.

E.A. 7213 stress vasculaire et tissulaire en transplantation, Strasbourg, France.

出版信息

Surg Endosc. 2017 Mar;31(3):1250-1256. doi: 10.1007/s00464-016-5099-z. Epub 2016 Jul 12.

Abstract

BACKGROUND

Lobectomy for benign lung disease is renowned to be technically complex and to be subjected to an increased complication rate. The objective of this study was to evaluate whether the results obtained with video-assisted surgery (VATS) in benign disease are comparable to those obtained in oncologic surgery, where VATS has been validated.

METHODS

We have reviewed the files of 246 consecutive patients who underwent VATS lobectomy from January 2012 to August 2015. The cohort was divided into two groups according to pathology (benign or malignant). Outcome parameters on scrutiny were demographics, pathology, duration of air leak, drainage and hospital stay, conversion, and perioperative complication rate. Comparisons were made with the χ test and Student's t test; any p value ≤0.05 was considered as significant.

RESULTS

Group 1 (36 patients) included patients who underwent lobectomy for benign disease and group 2 (210 patients) patients affected by lung cancer or pulmonary metastases. The two groups differed with reference to age (p < 0.001), history of cancer (p < 0.001), history of stroke (p = 0.05), and the presence of pleural adhesions (p = 0.03). There was no difference for duration of air leaks, chest tube drainage and hospital stay, conversion rate, and perioperative complication rate.

CONCLUSIONS

We conclude that pathology did not impact on outcomes after VATS lobectomy. This study suggests that VATS is as a safe option in selected patients with benign disease requiring lobectomy, despite a more complex technical context.

摘要

背景

因良性肺病行肺叶切除术在技术上被认为很复杂,且并发症发生率较高。本研究的目的是评估在良性疾病中采用电视辅助手术(VATS)所取得的结果是否与在已得到验证的肿瘤手术中所取得的结果相当。

方法

我们回顾了2012年1月至2015年8月连续接受VATS肺叶切除术的246例患者的病历。根据病理结果(良性或恶性)将该队列分为两组。仔细审查的结果参数包括人口统计学、病理、漏气持续时间、引流及住院时间、中转率和围手术期并发症发生率。采用χ检验和学生t检验进行比较;任何p值≤0.05均被视为具有统计学意义。

结果

第1组(36例患者)包括因良性疾病接受肺叶切除术的患者,第2组(210例患者)包括患有肺癌或肺转移瘤的患者。两组在年龄(p<0.001)、癌症病史(p<0.001)、中风病史(p=0.05)和胸膜粘连情况(p=0.03)方面存在差异。在漏气持续时间、胸腔闭式引流和住院时间、中转率及围手术期并发症发生率方面无差异。

结论

我们得出结论,病理结果对VATS肺叶切除术后的结局没有影响。本研究表明,对于需要行肺叶切除术的选定良性疾病患者,VATS是一种安全的选择,尽管技术背景更为复杂。

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