Yang Xingguo, Yu Lei, Yu Zhen, Gao Xiang, Du Xin
Department of Thoracic Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Zhongguo Fei Ai Za Zhi. 2022 Apr 20;25(4):253-258. doi: 10.3779/j.issn.1009-3419.2022.101.15.
In recent years, with the advancement of minimally invasive techniques, thoracoscopic thymoma resection has experienced a development process from three-port video-assisted thoracic surgery (VATS) to two-port (TP) and single-port (SP) variants. However, the feasibility and safety of SP-VATS have not been generally recognized. This study intends to explore the safety and feasibility of SP-VATS in thymoma resection, in order to provide a reference for clinical surgicalselection.
The clinical data of 197 patients who underwent thoracoscopic thymoma resection in Beijing Tongren Hospital from January 2018 to September 2021 were retrospectively analyzed. The patients were divided into SP-VATS group (n=42) and TP-VATS group (n=155). After matching propensity scores, there is no statistically significant difference in preoperative baseline data between SP-VATS group and TP-VATS group. Among them, there were 17 males and 25 females with an average age of 28-72 (48.00±9.43) years in the SP-VATS group, and 20 males and 22 females with an average age of 30-75 (50.38±9.83) years in TP-VATS group. The clinical effects of the two groups were compared.
The operation was successfully completed in both groups, and there was no conversion to thoracotomy or increased surgical incisions. Compared with the TP-VATS group, the chest drainage time and hospital stay in the SP-VATS group were shorter [(2.95±0.76) d vs (3.33±0.85) d; (4.57±0.83) d vs (5.07±1.13) d], and the visual pain score at 24 h and 72 h after surgery were lower [(3.64±0.85) points vs (4.05±0.66) points; (2.33±0.75) points vs (3.07±0.68) points] (P<0.05). There was no statistically significant difference between the two groups in operation time [(130.00±26.23) min vs (135.24±27.03) min], intraoperative blood loss [(69.52±22.73) mL vs (82.38±49.23) mL] (P>0.05).
SP-VATS in thymoma is a safe, feasible, and less invasive procedure, with less postoperative pain and faster recovery than multi-port VATS.
近年来，随着微创技术的进步，胸腔镜下胸腺瘤切除术经历了从三孔电视辅助胸腔镜手术（VATS）到两孔（TP）和单孔（SP）术式的发展过程。然而，单孔VATS的可行性和安全性尚未得到普遍认可。本研究旨在探讨单孔VATS在胸腺瘤切除术中的安全性和可行性，为临床手术选择提供参考。
回顾性分析2018年1月至2021年9月在北京同仁医院接受胸腔镜下胸腺瘤切除术的197例患者的临床资料。将患者分为单孔VATS组（n = 42）和两孔VATS组（n = 155）。在进行倾向评分匹配后，单孔VATS组和两孔VATS组术前基线数据无统计学差异。其中，单孔VATS组男性17例，女性25例，平均年龄28 - 72（48.00±9.43）岁；两孔VATS组男性20例，女性22例，平均年龄30 - 75（50.38±9.83）岁。比较两组的临床效果。
两组手术均顺利完成，无中转开胸或增加手术切口情况。与两孔VATS组相比，单孔VATS组胸腔引流时间和住院时间更短[（2.95±0.76）天 vs （3.33±0.85）天；（4.57±0.83）天 vs （5.07±1.13）天]，术后24小时和72小时视觉疼痛评分更低[（3.64±0.85）分 vs （4.05±0.66）分；（2.33±0.75）分 vs （3.07±0.68）分]（P < 0.05）。两组手术时间[（130.00±26.23）分钟 vs （135.24±27.03）分钟]、术中出血量[（69.52±22.73）毫升 vs （82.38±49.23）毫升]比较，差异无统计学意义（P > 0.05）。
单孔VATS用于胸腺瘤切除是一种安全、可行且创伤较小的手术方式，与多孔VATS相比，术后疼痛轻、恢复快。
