Zhang Wang, Xu Honglei, Wen Wei, Wang Jun, Chen Liang, Zhu Quan
Department of Thoracic Surgery, Jiangsu Provincial People's Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Zhongguo Fei Ai Za Zhi. 2020 Oct 20;23(10):852-857. doi: 10.3779/j.issn.1009-3419.2020.101.41.
Anatomical segmentectomy is more and more widely used in lung nodules and early stage lung cancer. Postoperative lung air leakage is one of the common complications after surgery. This study aimed to explore the effect of the application of repair materials in precise segmentectomy under thoracoscopy in reducing postoperative lung air leakage.
This study included patients admitted to the Department of Thoracic Surgery of Jiangsu Provincial People's Hospital who were scheduled to undergo thoracoscopic segmentectomy from August 1, 2018 to July 31, 2019. According to the difference of the materials used in the treatment of the inter-segment interface during the operation: patients who used microporous polysaccharide hemostatic powder+fibrin adhesive glue+absorbable polyglycolic acid patch were divided into group A, and the patients with fibrin adhesive+absorbable polyglycolic acid patch were divided into group B. The preoperative basic information of all patients and the daily postoperative chest drainage volume, the indwelling time of the chest drainage tube, the chest radiograph before the chest drainage tube is removed, the chest radiograph after the chest drainage tube is removed, blood routine and postoperative hospital stay were collected and recorded, and the effect of the application of intraoperative repair materials on postoperative lung air leakage was analyzed.
There were statistically significant differences in the indwelling time of thoracic drainage tube (P=0.019) and postoperative hospital stay (P=0.017) between the two groups.
Compared with the use of the fibrin glue+absorbability polyglycolic acid patch, the use of microporous polysaccharide hemostatic powder+fibrin glue+absorbability polyglycolic acid patch in the treatment of the inter-segment interface during segmentectomy can better reduce the incidence of postoperative air leakage and shorten the postoperative hospital stay.
解剖性肺段切除术在肺结节及早期肺癌中的应用越来越广泛。术后肺漏气是手术常见的并发症之一。本研究旨在探讨修复材料在胸腔镜精准肺段切除术中的应用对减少术后肺漏气的效果。
本研究纳入2018年8月1日至2019年7月31日在江苏省人民医院胸外科拟行胸腔镜肺段切除术的患者。根据术中处理段间界面所用材料的不同:使用微孔多糖止血粉+纤维蛋白黏胶+可吸收聚乙醇酸补片的患者分为A组,使用纤维蛋白黏胶+可吸收聚乙醇酸补片的患者分为B组。收集并记录所有患者的术前基本信息、术后每日胸腔引流量、胸腔引流管留置时间、胸腔引流管拔除前胸部X线片、胸腔引流管拔除后胸部X线片、血常规及术后住院时间,分析术中应用修复材料对术后肺漏气的影响。
两组患者胸腔引流管留置时间(P=0.019)及术后住院时间(P=0.017)比较,差异有统计学意义。
与使用纤维蛋白黏胶+可吸收聚乙醇酸补片相比,在肺段切除术处理段间界面时使用微孔多糖止血粉+纤维蛋白黏胶+可吸收聚乙醇酸补片能更好地降低术后漏气发生率,缩短术后住院时间。