ObjectiveTo discuss the advantage and disadvantage of uniport video-assisted thoracic surgery (VATS) versus single utility port VATS in the surgical treatment of benign thoracic diseases. MethodsFrom January 2012 to December 2014, 125 patients with benign thoracic diseases who underwent VATS by the same performer were divided randomly into two groups including a uniport VATS group or a single utility port VATS group. There were 41 males and 24 females with a mean age of 47.5±16.6 years in the uniport VATS group. There were 39 males and 21 females with a mean age of 45.1±15.7 years in the single utility port VATS group. Then the patients were followed up. The perioperative data and follow-up results were compared between two groups. ResultsThe total 125 patients of operations were performed successfully according the established plan, without increasing incisions or transferring to thoracotomy. There were no statistical differences between two groups in operative time (48.9±11.3 min vs. 47.1±11.0 min), intraoperative bleeding volume (26.9±15.4 ml vs. 23.8±13.2 ml), postoperative 24 h chest tube drainage volume (81.5±36.9 ml vs. 77.3±31.2 ml), postoperative chest tube drainage time (2.8±2.0 d vs. 3.4±2.2 d), the pain score on the 3rd postoperative day (2.6±1.2 points vs. 2.6±1.3 points), average in-hospital stay (4.9±2.1 d vs. 5.1±2.2 d) or postoperative complications (P > 0.05). The patients were followed up for 3-24 months. All patients achieved satisfactory results with no recurrence. ConclusionsCompared with single utility port VATS, uniport VATS does not prolong operation time or consume more materials, and has advantages of minimally invasion and higher acceptance. It is a safe and feasible approach in surgical treatment of benign thoracic diseases and worthy of popularization and application.
目的探索單操作孔電視胸腔鏡手術治療胸部良性疾病的有效性和安全性。 方法回顧性分析2008年3月至2013年4月德陽市人民醫院單操作孔電視胸腔鏡手術治療胸部良性疾病186例患者的臨床資料，其中男101例、女85例，年齡15～65（30.1±5.3）歲。 結果全組患者無圍手術期死亡。手術時間18～88（47.2±7.6）min，術中出血量5.0～110.0（49.8±9.4）ml，患者術后住院時間7～16（9.2±2.1）d。2例因致密粘連轉為輔助小切口手術。自發性氣胸肺大泡切除術后當日及術后1～2 d出現持續肺漏氣3例，1例肺漏氣持續9 d，1例肺漏氣持續10 d，1例肺漏氣持續11 d，均經保守治療治愈。切口脂肪液化4例，換藥后治愈。術后肺部感染3例，經加強抗感染后治愈。隨訪3～24（6.8±3.2）個月，失訪18例，總體隨訪率90.3%（168/186）。隨訪期間氣胸復發4例，氣胸壓縮肺組織10%～20%，觀察5～8 d自行吸收，未再次手術；肺及縱隔良性病變無復發；結核患者術后抗癆治療12～18個月治愈。 結論單操作孔電視胸腔鏡手術治療胸部良性疾病創傷小，切口美觀，患者恢復快，手術安全，對適應證患者可作為手術方式。
目的 介紹胸部良性疾病經單孔胸腔鏡切除術后免胸腔引流管的臨床經驗。 方法 回顧性分析 2015 年 10 月至 2016 年 10 月我院胸外科 17 例行單孔胸腔鏡手術患者的臨床資料，其中男 9 例、女 8 例，年齡 33.8（17～58）歲。行肺大皰切除術 7 例，肺楔形切除術 9 例，交感神經烙斷術 1 例。 結果 所有患者均經單孔胸腔鏡手術有效切除，期間無中轉開胸或再次開操作孔，術后不放置胸腔引流管，手術時間為（60.3±8.2）min，術中出血量為（15.2±5.1）ml，術后第 1 d、2 d、3 d 疼痛視覺模擬評分（VAS） 為 6.5±2.2，5.8±2.1，3.5±1.3，術后舒適度評分分別為 8.6±1.3，術后早期下床活動時間為（1.0±0.3）d，切口甲級愈合率 100.0%。17 例患者均無心律失常、肺部感染等并發癥，術后隨訪 6 個月氣胸均無復發。 結論 合理選擇及嚴格基線評估，胸部良性疾病經單孔胸腔鏡切除術后免胸腔引流管是安全可行的，可能有利于患者術后快速康復。