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电视辅助胸腔镜手术(VATS)中切口保护套的使用方法及放置技巧。

Utilities and placement skills of the incision protective sleeve in video-assisted thoracoscopic surgery (VATS).

作者信息

Su Zhiyong, Wu Chao, Bian Hongliang, Zhou Zhiqiang, Jiang Tianshuo, Zhao Xin, Liu Fangchao, Zhang Yilei, Lin Keli, Gao Qingshan

机构信息

Department of Thoracic Surgery, Chifeng University Affiliated Hospital, Chifeng, China.

Department of Obstetrics and Gynecology, Chifeng University Affiliated Hospital, Chifeng, China.

出版信息

J Thorac Dis. 2020 Dec;12(12):7272-7280. doi: 10.21037/jtd-20-2703.

Abstract

BACKGROUND

The incision protective sleeve can protect incisions and help to establish an operating port and thus has been widely applied in thoracic surgeries. However, its other utilities are often neglected. This article explores the additional functions and placement techniques of incision protective sleeves in video-assisted transthoracic surgery (VATS).

METHODS

Operators with different surgical experience were divided into three groups: resident group, attending surgeon group, and professor group. Each group independently chose one of the four surgical maneuvers, and the incision protective sleeve was placed during the operation. Up to 200 operations were randomly selected in each group, and the patients' gender, age, incision site, incision length, the operator's experience, and the time and technique of incision protective sleeve placement were recorded. CT was performed to measure the thickness of chest wall and the width of intercostal spaces. Data were analyzed using SPSS 21.0 software package. Multivariate linear regression analysis was performed was performed for the time required for incision protective sleeve placement.

RESULTS

The operator's experience was inversely related to the time required for incision protective sleeve placement, width of intercostal spaces was negatively correlated with operative time, chest wall thickness and incision length were positively correlated with operative time. Among the maneuvers, incision protective sleeve placement skills were significant different.

CONCLUSIONS

The placement of the incision protective sleeve for VATS is affected by multiple factors, which are not only related to the patient's condition, chest wall thickness and intercostal space, but also closely related to the operator's experience and the manipulation adopted.

摘要

背景

切口保护套可保护切口并有助于建立手术操作端口,因此已在胸外科手术中广泛应用。然而,其其他用途常常被忽视。本文探讨了切口保护套在电视辅助胸腔镜手术(VATS)中的附加功能及放置技术。

方法

将具有不同手术经验的手术者分为三组:住院医师组、主治医师组和教授组。每组独立选择四种手术操作之一,并在手术过程中放置切口保护套。每组随机选取200例手术,记录患者的性别、年龄、切口部位、切口长度、手术者经验以及切口保护套的放置时间和技术。进行CT检查以测量胸壁厚度和肋间隙宽度。使用SPSS 21.0软件包进行数据分析。对切口保护套放置所需时间进行多因素线性回归分析。

结果

手术者经验与切口保护套放置所需时间呈负相关,肋间隙宽度与手术时间呈负相关,胸壁厚度和切口长度与手术时间呈正相关。在各种操作中,切口保护套的放置技巧存在显著差异。

结论

VATS中切口保护套的放置受多种因素影响,这些因素不仅与患者病情、胸壁厚度和肋间隙有关,还与手术者经验及所采用的操作密切相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aca6/7797868/4159a9ad5b2f/jtd-12-12-7272-f1.jpg

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