Bernard A, Bélichard C, Goudet P, Lombard J N, Viard H
Service de Chirurgie Thoracique, Hôpital du Bocage, Dijon.
Rev Mal Respir. 1993;10(5):433-6.
The aims of this study were to assess the advantages of surgical thoracoscopy versus thoracotomy. Two 16-patient groups (thoracotomy, thoracoscopy) were compared. They were equivalent with regards to technique, age, etiology and lung dystrophy. Patients were called by phone to evaluate the surgical and functional results. The questionnaire was filled out by an independent physician who ignored the surgical technique used. Hospital stay was 7 +/- 2 days for thoracoscopy versus 11.5 +/- 5 days for thoracotomy (p < 0.003). During the J30 to J60 period of time, pain was mild in 94% of thoracoscopy cases and severe or unbearable in 69% of thoracotomy cases (p < 0.002). Mobility of the shoulder was fully recovered in all thoracoscopy patients within the first month versus only 62% of recovery at 3 months in the thoracotomy group (p < 0.0001). Working was possible at 1 +/- 0.8 month in the thoracoscopy group versus 2.6 +/- 0.8 months in the thoracotomy group (p < 0.002). Leisure activities were resumed at 2 +/- 1 month in the thoracoscopy group versus 4 +/- 1 months in the thoracotomy group (p < 0.0005). Only one relapse occurred in the thoracoscopy group. Thoracoscopy prevents the drawbacks of thoracotomy but keeps the same efficiency in the treatment of pneumothorax.
本研究的目的是评估手术胸腔镜检查与开胸手术相比的优势。比较了两组各16例患者(开胸手术组、胸腔镜检查组)。他们在技术、年龄、病因和肺营养不良方面相当。通过电话联系患者以评估手术和功能结果。问卷由一名不了解所采用手术技术的独立医生填写。胸腔镜检查组的住院时间为7±2天,而开胸手术组为11.5±5天(p<0.003)。在术后30至60天期间,94%的胸腔镜检查病例疼痛轻微,而69%的开胸手术病例疼痛严重或难以忍受(p<0.002)。所有胸腔镜检查患者的肩部活动在第一个月内完全恢复,而开胸手术组在3个月时只有62%恢复(p<0.0001)。胸腔镜检查组在1±0.8个月后可以工作,而开胸手术组为2.6±0.8个月(p<0.002)。胸腔镜检查组在2±1个月后恢复休闲活动,而开胸手术组为4±1个月(p<0.0005)。胸腔镜检查组仅发生1例复发。胸腔镜检查可避免开胸手术的缺点,但在气胸治疗中保持相同的疗效。