Applicaiton effect of blunt dissection for myotomy of incision in single-port thoracoscopic lung wedge resection

GONG Yi-fei; ZHAI Jian-bin; LU Xue-lei; ZHAO Liang

doi:10.11659/jjssx.09E024159

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Applicaiton effect of blunt dissection for myotomy of incision in single-port thoracoscopic lung wedge resection

Clinical Research | 更新时间：2025-05-26

- Applicaiton effect of blunt dissection for myotomy of incision in single-port thoracoscopic lung wedge resection
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 34, Issue 5, Pages: 440-443(2025)
- 作者机构：
  
  河北中医药大学第一附属医院外三科，河北石家庄 050011
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.09E024159
  CLC： R655.3
- Received：30 September 2024，
  
  Published：25 May 2025
- 稿件说明：
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龚一非,翟建宾,路雪雷等.单孔胸腔镜肺楔形切除术中钝性分离切口肌层的应用效果[J].局解手术学杂志,2025,34(05):440-443.

GONG Yi-fei,ZHAI Jian-bin,LU Xue-lei,et al.Applicaiton effect of blunt dissection for myotomy of incision in single-port thoracoscopic lung wedge resection[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(05):440-443.
龚一非,翟建宾,路雪雷等.单孔胸腔镜肺楔形切除术中钝性分离切口肌层的应用效果[J].局解手术学杂志,2025,34(05):440-443. DOI： 10.11659/jjssx.09E024159.

GONG Yi-fei,ZHAI Jian-bin,LU Xue-lei,et al.Applicaiton effect of blunt dissection for myotomy of incision in single-port thoracoscopic lung wedge resection[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(05):440-443. DOI： 10.11659/jjssx.09E024159.

摘要

目的

分析钝性分离切口肌层在单孔胸腔镜肺楔形切除术中的应用效果。

方法

选取2024年1―6月在我院行单孔胸腔镜肺楔形切除手术的患者，按照随机数字表法分为观察组（32例，术中钝性分离切口肌层）和对照组（35例，术中采用传统电刀分离切口肌层）。比较2组患者麻醉时间、手术时间、术中出血量、术后最早下床时间、地佐辛使用量及术后各时段静息和咳嗽时疼痛视觉模拟量表（VAS）评分。

结果

2组患者麻醉时间、手术时间、术中出血量、地佐辛使用量比较，差异无统计学意义（

0.05）；观察组患者最早下床时间短于对照组，差异具有统计学意义（

0.05）。2组患者术后6 h、12 h静息时VAS评分无显著差异（

0.05），术后24 h、48 h静息时VAS评分差异具有统计学意义（

0.05）；2组患者术后6 h咳嗽时VAS评分比较，差异无统计学意义（

0.05），术后12 h、24 h、48 h咳嗽时VAS评分比较，差异具有统计学意义（

0.05）。

结论

在单孔胸腔镜肺楔形切除术中，钝性分离肌层较传统电刀分离能减轻患者术后疼痛，促进术后下床活动，有利于术后康复。

Abstract

Objective

To analyze the application effect of blunt dissection for myotomy of incision in single-port thoracoscopic lung wedge resection.

Methods

Patients who underwent single-port thoracoscopic lung wedge resection in our hospital from January to June 2024 were selected and divided into the observation group（32 cases，received blunt dissection for myotomy of incision during the surgery） and the control group（35 cases，received electrosurgical knife for myotomy of incision during the surgery） according to random number table method. The anesthesia time，operation time，intraoperative blood loss，the earliest time to get out of bed after the operation，the dosage of dezocine，and the resting and cough visual analogue scale （VAS） scores in each postoperative period of patients in the two groups were compared.

Results

There was no significant difference in terms of anesthesia time，operation time，intraoperative blood loss，or dosage of dezocine of patients between the two groups （

0.05）. The earliest time to get out of bed after operation of patients in the observation group was shorter than that in the control group，with significant difference （

0.05）. No significant difference was observed in resting VAS scores 6 hours or 12 hours after operation of patients in both two groups（

0.05），but significant differences were found in resting VAS scores 24 hours and 48 hours after operation between the two groups（

0.05）. No significant difference was found in cough VAS scores 6 hours after operation of patients between the two groups （

0.05），but significant differences were observed in cough VAS scores 12 hours，24 hours，and 48 hours after operation between the two groups（

0.05）.

Conclusion

Compared with electrosurgical knife for myotomy of incision，blunt dissection for myotomy of incision in single-port thoracoscopic lung wedge resection can reduce postoperative pain，promote postoperative ambulation for patients，which is beneficial to postoperative recovery.

关键词

Keywords

references

Sun K ， Liu D ， Chen J ， et al . Moderate-severe postoperative pain in patients undergoing video-assisted thoracoscopic surgery：a retrospective study ［J］. Sci Rep ， 2020 ， 10 （ 1 ）： 795 . doi： 10.1038/s41598-020-57620-8 http://dx.doi.org/10.1038/s41598-020-57620-8 .

Fletcher D ， Stamer UM ， Pogatzki-Zahn E ， et al . Chronic postsurgical pain in Europe：an observational study ［J］. Eur J Anaesthesiol ， 2015 ， 32 （ 10 ）： 725 - 734 . doi： 10.1097/EJA.0000000000000319 http://dx.doi.org/10.1097/EJA.0000000000000319 .

Gerbershagen HJ ， Pogatzki-Zahn E ， Aduckathil S ， et al . Procedure-specific risk factor analysis for the development of severe postoperative pain ［J］. Anesthesiology ， 2014 ， 120 （ 5 ）： 1237 - 1245 . doi： 10.1097/ALN.0000000000000108 http://dx.doi.org/10.1097/ALN.0000000000000108 .

朱云柯，林琳，廖虎，等 . 中国胸外科围手术期疼痛管理专家共识（2018版）［J］. 中国胸心血管外科临床杂志， 2018 ， 25 （ 11 ）： 921 - 928 . doi： 10.7507/1007-4848.201810052 http://dx.doi.org/10.7507/1007-4848.201810052 .

Xiang Z ， Wu B ， Zhang X ， et al . Uniportal versus multiportal video-assisted thoracoscopic segmentectomy for non-small cell lung cancer：a systematic review and meta-analysis ［J］. Surg Today ， 2023 ， 53 （ 3 ）： 293 - 305 . doi： 10.1007/s00595-021-02442-y http://dx.doi.org/10.1007/s00595-021-02442-y .

Hu CG ， Zheng K ， Liu GH ， et al . Effectiveness and postoperative pain level of single-port versus two-port thoracoscopic lobectomy for lung cancer：a retrospective cohort study ［J］. Gen Thorac Cardiovasc Surg ， 2021 ， 69 （ 2 ）： 318 - 325 . doi： 10.1007/s11748-020-01479-z http://dx.doi.org/10.1007/s11748-020-01479-z .

李晓亮，姚益，刘蔡杨，等 . 单孔胸腔镜肺叶切除术治疗老年患者非小细胞肺癌的效果观察［J］. 局解手术学杂志， 2021 ， 30 （ 8 ）： 723 - 726 . doi： 10.11659/jjssx.02E021074 http://dx.doi.org/10.11659/jjssx.02E021074 .

Liang XL ， An R ， Chen Q ， et al . The analgesic effects of thoracic paravertebral block versus thoracic epidural anesthesia after thoracoscopic surgery：a meta-analysis ［J］. Pain Res ， 2021 ， 14 ： 815 - 825 . doi： 10.2147/JPR.S299595 http://dx.doi.org/10.2147/JPR.S299595 .

Sihoe ADL . Uniportal lung cancer surgery：state of the evidence ［J］. Ann Thorac Surg ， 2019 ， 107 （ 3 ）： 962 - 972 . doi： 10.1016/j.athoracsur. 2018.08.023 http://dx.doi.org/10.1016/j.athoracsur.2018.08.023 .

Abouarab AA ， Rahouma M ， Kamel M ， et al . Single versus multi-incisional video-assisted thoracic surgery：a systematic review and meta-analysis ［J］. Laparoendosc Adv Surg Tech A ， 2018 ， 28 （ 2 ）： 174 - 185 . doi： 10.1089/lap.2017.0446 http://dx.doi.org/10.1089/lap.2017.0446 .

孙耀光，焦鹏，佟宏峰，等 . 单孔与两孔胸腔镜肺叶切除治疗肺癌的对比研究［J］. 中国微创外科杂志， 2017 ， 17 （ 3 ）： 224 - 227 . doi： 10.3969/j.issn.1009-6604.2017.03.009 http://dx.doi.org/10.3969/j.issn.1009-6604.2017.03.009 .

Guerra-Londono CE ， Privorotskiy A ， Cozowicz C ， et al . Assessment of intercostal nerve block analgesia for thoracic surgery：a systematic review and meta-analysis ［J］. JAMA Netw Open ， 2021 ， 4 （ 11 ）： e2133394 . doi： 10.1001/jamanetworkopen.2021.33394 http://dx.doi.org/10.1001/jamanetworkopen.2021.33394 .

Palleschi A ， Mattioni G ， Mendogni P ， et al . A real-world experience of transition to robotic-assisted thoracic surgery（RATS） for lung resections ［J］. Front Surg ， 2023 ， 10 ： 1127627 . doi： 10.3389/fsurg. 2023.1127627 http://dx.doi.org/10.3389/fsurg.2023.1127627 .

柯建锋 . 高频电刀的安全问题及常见故障维修［J］. 中国医疗器械信息， 2022 ， 28 （ 20 ）： 161 - 164 . doi： 10.15971/j.cnki.cmdi.2022. 20.008 http://dx.doi.org/10.15971/j.cnki.cmdi.2022.20.008 .

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