摘要
目的比较经右胸与左胸2种入路胸腔镜全胸腺切除术的临床效果。方法回顾性分析2011年1月～2017年12月33例胸腔镜全胸腺切除术,其中经右胸入路18例(右胸组),经左胸入路15例(左胸组),比较2组手术时间、术中出血量、术后胸管留置时间、术后住院时间以及并发症发生率。结果 2组手术顺利,无中转开放手术,无围术期死亡。右胸组和左胸组手术时间[(109.7±32.5) min vs.(105.3±20.5) min,t=0.472,P=0.641]、中位术中出血量[10.0 ml(10～100ml) vs.10.0 ml(5～50 ml),Z=-0.505,P=0.656]、术后胸管留置时间[(4.7±1.7) d vs.(5.9±2.3) d,t=-1.742,P=0.091]、术后住院时间[(7.4±2.1) d vs.(7.5±2.3) d,t=-0.118,P=0.907]和并发症(2例vs.1例,Fisher精确概率法,P=1.000)均无显著差异。结论经右胸和左胸入路行胸腔镜全胸腺切除术安全可行,手术效果相当,术者可以依据个人的操作习惯及病灶的位置合理选择手术路径。
Objective To compare clinical outcomes of thoracoscopic extended thymectomy through right or left thoracic approach.Methods Clinical data of 33 patients who received thoracoscopic extended thymectomy from January 2011 to December2017 were retrospectively analyzed.Of these patients,there were 18 cases of right approach surgery(right-side group) and 15 cases of left approach surgery(left-side group).The duration of surgery,amount of intraoperative blood loss,duration of chest drainage,postoperative hospital stay and postoperative complications were compared between the two groups.Results The operations were successful in both groups.No patients needed conversion to open surgery.No peri-operative death occurred.There were no significant differences between the right-side group and the left-side group in duration of surgery [(109.7±32.5) min vs.(105.3±20.5) min,t=0.472,P=0.641],amount of intraoperative blood loss [10.0(10-100) ml vs.10.0(5-50) ml,Z=-0.505,P=0.656],duration of chest drainage [(4.7±1.7) days vs.(5.9±2.3) days,t=-1.742,P=0.091],postoperative hospital stay [(7.4±2.1) days vs.(7.5±2.3) days,t=-0.118,P=0.907]and postoperative complications(2 cases vs.1 case,Fisher's exact test,P=1.000) between the two groups.Conclusions Both right and left thoracic approach for video-assisted thoracoscopic extended thymectomy are safe and feasible.The laterality of approach remains largely on surgeon preferences and location of the lesion.
引文
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