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两种确定肺段间平面的胸腔镜精准肺段切除术的临床对照研究
A controlled clinical study of two types of thoracoscopic precision segmentectomy for determining intersegmental plane
- 局解手术学杂志 2024年33卷第3期 页码：264-267
- 作者机构：
安庆市立医院心胸外科，安徽 安庆 246003
- 作者简介：
陈剑，E-mail：ChenJianYC@126.com
- 基金信息：安徽省2021年度重点研究与开发计划项目(2104h08020278)
DOI：10.11659/jjssx.04E023090
中图分类号： R734.2纸质出版日期：2024-03-25，
收稿日期：2023-04-20，
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陈大庆,詹必成,周新涛等.两种确定肺段间平面的胸腔镜精准肺段切除术的临床对照研究[J].局解手术学杂志,2024,33(03):264-267.
CHEN Da-qing,ZHAN Bi-cheng,ZHOU Xin-tao,et al.A controlled clinical study of two types of thoracoscopic precision segmentectomy for determining intersegmental plane[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(03):264-267.
陈大庆,詹必成,周新涛等.两种确定肺段间平面的胸腔镜精准肺段切除术的临床对照研究[J].局解手术学杂志,2024,33(03):264-267. DOI： 10.11659/jjssx.04E023090.
CHEN Da-qing,ZHAN Bi-cheng,ZHOU Xin-tao,et al.A controlled clinical study of two types of thoracoscopic precision segmentectomy for determining intersegmental plane[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(03):264-267. DOI： 10.11659/jjssx.04E023090.
摘要
目的
2
比较单纯动脉结扎法与改良膨胀萎陷法在胸腔镜精准肺段切除术中确定肺段间平面的应用效果。
方法
2
前瞻性纳入2021年8月至2023年2月于本院行胸腔镜精准肺段切除术的80例患者，采用随机数字表法将患者分为观察组和对照组，每组40例。观察组患者采用单纯动脉结扎法确定肺段间平面，对照组患者采用改良膨胀萎陷法确定肺段间平面。比较2组患者围术期相关指标、肺功能指标、术后并发症及随访情况。
结果
2
观察组患者手术时间及术中出血量均显著短/少于对照组（
P
<
0.05）；而2组患者段间平面显现时间、术后总引流量、引流管留置时间、术后住院时间及肺段切除分布情况比较，差异均无统计学意义（
P
>
0.05）。术后2组患者用力肺活量占预计值百分比（FVC%pred）、第1秒用力呼气容积占预计值百分比（FEV1%pred）较术前均显著降低（
P
<
0.05），且观察组患者术后FVC%pred、FEV1%pred显著高于对照组（
P
<
0.05）。2组患者术后各并发症的发生情况比较，差异均无统计学意义（
P
>
0.05）。随访期间所有患者均未出现死亡、肿瘤局部复发或远处转移情况。
结论
2
在胸腔镜精准肺段切除术中应用单纯动脉结扎法确定段间平面较改良膨胀萎陷法具有操作简便、损伤小、对患者肺功能影响小等显著优势，安全性较高，是一种可行且有效的技术。
Abstract
Objective
2
To compare the application effects of simple artery ligation and modified inflation-deflation method in determining the lung intersegment plane during thoracoscopic precision segmentectomy.
Methods
2
A total of 80 patients who underwent thoracoscopic precision segmentectomy in our hospital from August 2021 to February 2023 were prospectively included and divided into the observation group and the control group by random number table method， with 40 cases in each group. Patients in the observation group were determined the lung intersegment plane by simple artery ligation， while patients in the control group were determined the lung intersegment plane by modified inflation-deflation method. The perioperative related indexes， lung function indexes， postoperative complications and follow-up of patients between the two groups were compared.
Results
2
The operative time and blood loss of patients in the observation group were significantly shorter/lower than those in the control group （
P
<
0.05）. There was no significant difference in the time to reveal the intersegmental planes， total drainage volume after operation， indwelling time of drainage tube， postoperative hospital stay or lung segmentectomy distribution of patients between the two groups （
P
>
0.05）. The percentage of forced vital capacity to the predicted values （FVC%pred） and percentage of forced expiratory volume in 1 second to the predicted values （FEV1%pred） after operation of patients in the two groups were significantly decreased compared with those before operation （
P
<
0.05）， and FVC%pred and FEV1%pred after operation of patients in the observation group were significantly higher than those in the control group （
P
<
0.05）. There was no statistically significant difference in the occurrence of postoperative complications of patients between the two groups （
P
>
0.05）. There was no death， local recurrence or distant metastasis occurred in all patients during follow-up.
Conclusion
2
Compared with the modified inflation-deflation method， the application of simple artery ligation to determine the intersegment plane during thoracoscopic precision segmentectomy has significant advantages such as simple operation， less injury， and less impact on the lung function of patients， which is a feasible and effective technique， with high safety.
关键词
段间平面胸腔镜肺段切除术改良膨胀萎陷法单纯动脉结扎法
Keywords
intersegmental planethoracoscopesegmentectomymodified inflation-deflation methodsimple arterial ligation
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