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三维(3D)-计算机断层支气管造影和血管造影联合 3D 视频辅助胸腔镜手术(VATS)与传统 2D-VATS 解剖性肺段切除术治疗非小细胞肺癌的比较。

Three-dimensional (3D)- computed tomography bronchography and angiography combined with 3D-video-assisted thoracic surgery (VATS) versus conventional 2D-VATS anatomic pulmonary segmentectomy for the treatment of non-small cell lung cancer.

机构信息

Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China.

Department of Thoracic Surgery, Suzhou Municipal Hospital North District, Nanjing Medical University, Suzhou, China.

出版信息

Thorac Cancer. 2018 Feb;9(2):305-309. doi: 10.1111/1759-7714.12585. Epub 2018 Jan 3.

Abstract

BACKGROUND

Compared to the pulmonary lobe, the anatomical structure of the pulmonary segment is relatively complex and prone to variation, thus the risk and difficulty of segmentectomy is increased. We compared three-dimensional computed tomography bronchography and angiography (3D-CTBA) combined with 3D video-assisted thoracic surgery (3D-VATS) to perform segmentectomy to conventional two-dimensional (2D)-VATS for the treatment of non-small cell lung cancer (NSCLC).

METHODS

We retrospectively reviewed the data of randomly selected patients who underwent 3D-CTBA combined with 3D-VATS (3D-CTBA-VATS) or 2D-VATS at the Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University Hospital, from January 2014 to May 2017.

RESULTS

The operative duration of 3D group was significantly shorter than the 2D group (P < 0.05). There was no significant difference in the number of dissected lymph nodes between the two groups (P > 0.05). The extent of intraoperative bleeding and postoperative drainage in the 3D group was significantly lower than in the 2D group (P < 0.05). Chest tube duration in the 3D group was shorter than in the 2D group (P < 0.05). Incidences of pulmonary infection, atelectasis, and arrhythmia were not statistically different between the two groups (P > 0.05). However, hemoptysis and pulmonary air leakage (>3d) occurred significantly less frequently in the 3D than in the 2D group (P < 0.05).

CONCLUSION

3D-CTBA-VATS is a more accurate and smooth technique and leads to reduced intraoperative and postoperative complications.

摘要

背景

与肺叶相比,肺段的解剖结构较为复杂且容易发生变异,因此段切除术的风险和难度增加。我们比较了三维计算机断层支气管造影和血管造影(3D-CTBA)联合三维电视辅助胸腔镜手术(3D-VATS)与传统二维(2D)-VATS 治疗非小细胞肺癌(NSCLC)的效果。

方法

我们回顾性分析了 2014 年 1 月至 2017 年 5 月在苏州大学附属第一医院胸外科行 3D-CTBA 联合 3D-VATS(3D-CTBA-VATS)或 2D-VATS 的随机选择患者的数据。

结果

3D 组的手术时间明显短于 2D 组(P < 0.05)。两组之间的淋巴结清扫数量无显著差异(P > 0.05)。3D 组术中出血量和术后引流量明显低于 2D 组(P < 0.05)。3D 组的胸腔引流管留置时间短于 2D 组(P < 0.05)。两组的肺部感染、肺不张和心律失常发生率无统计学差异(P > 0.05)。然而,3D 组的咯血和肺漏气(>3d)发生率明显低于 2D 组(P < 0.05)。

结论

3D-CTBA-VATS 是一种更准确、更流畅的技术,可减少术中及术后并发症。

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