Lu Ting-Yu, Chen Jian-Xun, Chen Pin-Ru, Lin Yu-Sen, Chen Chien-Kuang, Kao Pei-Yu, Huang Tzu-Ming, Fang Hsin-Yuan
Division of Thoracic Surgery, Department of Surgery, China Medical University Hospital, No. 2, Yude Rd., North Dist., 404, Taichung City, Taiwan.
Surg Today. 2017 May;47(5):606-610. doi: 10.1007/s00595-016-1414-5. Epub 2016 Sep 29.
To evaluate the outcomes of patients who underwent thoracoscopic wedge resection without chest drain placement.
The subjects of this retrospective study were 89 patients, who underwent thoracoscopic wedge resection at our hospital between January, 2013 and July, 2015. A total of 45 patients whose underlying condition did not meet the following criteria were assigned to the "chest drain placement group" (group A): peripheral lesions, healthy lung parenchyma, no intraoperative air leaks, hemorrhage or effusion accumulation, and no pleural adhesion. The other 44 patients whose underlying condition met the criteria were assigned to the "no chest drain placement group" (group B). Patient characteristics, specimen data, and postoperative conditions were analyzed and compared between the groups.
Group A patients had poorer forced expiratory volume in one second (FEV1) values, less normal spirometric results, significantly higher resected lung volume, a greater maximum tumor-pleura distance, and a larger maximum tumor size. They also had a longer postoperative hospital stay. There was no difference between the two groups in postoperative complications.
Avoiding chest drain placement after a thoracoscopic wedge resection appears to be safe and beneficial for patients who have small peripheral lesions and healthy lung parenchyma.
评估接受胸腔镜楔形切除术且未放置胸腔引流管的患者的治疗效果。
本回顾性研究的对象为2013年1月至2015年7月期间在我院接受胸腔镜楔形切除术的89例患者。共有45例基础病情不符合以下标准的患者被分配至“胸腔引流管放置组”(A组):周围型病变、肺实质健康、术中无漏气、出血或积液积聚,且无胸膜粘连。其他44例基础病情符合标准的患者被分配至“未放置胸腔引流管组”(B组)。对两组患者的特征、标本数据及术后情况进行分析和比较。
A组患者的一秒用力呼气容积(FEV1)值较差,肺功能测定结果正常的比例较低,切除的肺体积显著更大,肿瘤与胸膜的最大距离更大,最大肿瘤尺寸更大。他们的术后住院时间也更长。两组患者术后并发症无差异。
对于有小的周围型病变且肺实质健康的患者,胸腔镜楔形切除术后避免放置胸腔引流管似乎是安全且有益的。