[1]查鹏 陈艳艳 张蔚萱 梁正**.左右侧胸腔镜肺上叶切除术后胸腔引流情况的对照研究[J].中国微创外科杂志,2021,01(3):253-256.
 Cha Peng,Chen Yanyan,Zhang Weixuan,et al.A Controlled Study on Postoperative Thoracic Drainage After Thoracoscopic Lobectomy Between Left and Right Superior Lobe[J].Chinese Journal of Minimally Invasive Surgery,2021,01(3):253-256.
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左右侧胸腔镜肺上叶切除术后胸腔引流情况的对照研究()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2021年3期
页码:
253-256
栏目:
临床研究
出版日期:
2021-04-01

文章信息/Info

Title:
A Controlled Study on Postoperative Thoracic Drainage After Thoracoscopic Lobectomy Between Left and Right Superior Lobe
作者:
查鹏 陈艳艳 张蔚萱 梁正**
(北京大学国际医院胸外科,北京102206)
Author(s):
Cha Peng Chen Yanyan Zhang Weixuan et al.
Department of Thoracic Surgery, Peking University International Hospital, Beijing 102206, China
关键词:
电视胸腔镜手术肺叶切除术胸腔引流
Keywords:
Videoassisted thoracoscopic surgeryLobectomyThoracic drainage
文献标志码:
A
摘要:
目的对比左右侧胸腔镜肺上叶切除术后胸腔引流情况,指导优化胸腔引流策略。方法回顾性分析2016年1月~2020年9月53例三孔胸腔镜肺上叶切除术资料,左肺上叶30例,右肺上叶23例,术后均采用双管引流。比较2组术后引流时间、肺复张时间、拔管延迟(引流>7天)比例。 结果53例均顺利完成手术。2组手术时间、麻醉时间、术中出血量差异无统计学意义(P>0.05)。左肺上叶术后引流时间[(9.6±7.7)d]长于右肺上叶[(7.3±4.5)d],但差异无统计学意义(t=1.290,P=0.203)。左肺上叶肺复张时间[(6.0±8.4)d]显著长于右肺上叶[(2.6±2.8)d](t=2.123,P=0.041)。2组术后引流总量差异无统计学意义(P>0.05)。左肺上叶拔管延迟比例[43.3%(13/30)]高于右肺上叶[26.1%(6/23)],但差异无统计学意义(χ2=1.684, P=0.194)。结论胸腔镜右肺上叶切除术后肺复张快,可以考虑优化引流策略;胸腔镜左肺上叶切除术后仍有必要采用双管引流。
Abstract:
ObjectiveTo compare the postoperative thoracic drainage in patients receiving thoracoscopic lobectomy between left and right superior lobe, in order to guide the improvement of thoracic drainage strategy.MethodsClinical data of 53 patients who underwent threeport thoracoscopic lobectomy of superior lobe from January 2016 to September 2020, including 30 patients of left superior lobe and 23 patients of right superior lobe, all of whom accepted double tube thoracic drainage after operation, were retrospectively analyzed. Measurements including the time of postoperative drainage, the time of lung recruitment and the rate of delayed extubation (postoperative drainage time >7 d) were compared between the two groups.ResultsAll the 53 patients successfully underwent thoracoscopic lobectomy of superior lobe. The differences in operation time, anesthesia time and the amount of intraoperative blood loss between the two groups were not statistically significant (P>0.05). The postoperative drainage time of left superior lobe group [(9.6±7.7) d] was longer than that of right superior lobe group [(7.3±4.5) d], but the difference was not statistically significant (t=1.290,P=0.203). The time of lung recruitment in the left superior lobe group [(6.0±8.4) d] was significantly longer than that in the right superior lobe group [(2.6±2.8) d, t=2.123, P=0.041]. The difference in the total amount of postoperative drainage between the two groups was not statistically significant (P>0.05). The rate of delayed extubation in the left superior lobe group was 43.3% (13/30), which was higher than that in the right superior lobe group [26.1% (6/23)], but the difference was not statistically significant (χ2=1.684, P=0.194).ConclusionCompared with the left superior lobe, the lung recruitment after thoracoscopic lobectomy of right superior lobe resection is faster, so the improvement of thoracic drainage strategy can be considered, while it is still necessary to adopt double tube thoracic drainage after thoracoscopic lobectomy of left superior lobe.

参考文献/References:

[1]朱征,张明,王勇,等.单孔全胸腔镜解剖性肺段切除术治疗早期非小细胞肺癌.中国微创外科杂志,2019,19(10):887-889,893.
[2]Ginsberg RJ,Rubinstein LV.Randomized trial of lobectomy versus limited resection for T1 N0 nonsmall cell lung cancer.Lung Cancer Study Group.Ann Thorac Surg,1995,60(3):615-622.
[3]马超,孙耀光,田文鑫,等.单操作孔全胸腔镜左肺上叶切除术246例.中国微创外科杂志,2017,17(8):680-682,687.
[4]田文鑫,佟宏峰,孙耀光,等.两孔、三孔胸腔镜与开放肺叶切除治疗肺癌的对比研究.中国微创外科杂志,2014,14(11):994-997,1010.
[5]钟斌,吴奇勇,童继春,等.胸腔镜肺段或肺叶切除术治疗肺磨玻璃结节的比较研究. 中国微创外科杂志,2017,17(1):62-64,68.
[6]邱斌,冯飞跃,高树庚.胸腔镜肺上叶切除术后单、双胸管引流的前瞻性随机对照研究.中华胸心血管外科杂志,2016,32(3):162-164.
[7]Petrella F,Spaggiari L.Prolonged air leak after pulmonary lobectomy.J Thorac Dis,2019,11(Suppl 15):S1976-S1978.
[8]Dindo D,Demartines N,Clavien PA.Classification of surgical complications:a new proposal with evaluation in a cohort of 6336 patients and results of a survey.Ann Surg,2004,240(2):205-213.
[9]刘晓青,赵菲,戴纪刚,等.肺癌术后单管与双管胸腔闭式引流疗效比较的系统评价与Meta分析.中国胸心血管外科临床杂志,2019,26(6):583-589.
[10]戴维,冯飞跃,王大力.肺叶切除术后单、双胸腔引流管的临床应用.临床肺科杂志,2013,18(2):327-329.
[11]丁淳,金跃辉,周海燕,等.胸腔闭式引流瓶的研究进展.中华胸部外科电子杂志,2017,4(4):266-268.
[12]Tanaka M,Sagawa M,Usuda K,et al.Postoperative drainage with one chest tube is appropriate for pulmonary lobectomy:a randomized trial.Tohoku J Exp Med,2014,232(1):55-61.
[13]周勇,陈保骏,王文公,等.单操作孔完全胸腔镜非小细胞肺癌根治术.临床外科杂志,2016,24(3):217-218.
[14]曹纪伟,朱红军.单孔全胸腔镜肺叶切除术中不同胸腔引流方案对引流效果、疼痛程度及引流相关并发症的影响.腹腔镜外科杂志,2018,23(1):44-47.
[15]吴正杰.开胸手术患者发生术后肺栓塞的相关危险因素研究及预防.临床肺科杂志,2016,21(5):825-827.
[16]Li SJ,Zhou K,Li YJ,et al.Efficacy of the fissureless technique on decreasing the incidence of prolonged air leak after pulmonary lobectomy:a systematic review and metaanalysis. Int J Surg,2017,42:1-10.
[17]Li S,Lv W,Zhou K,et al.Does the fissureless technique decrease the incidence of prolonged air leak after pulmonary lobectomy?Interact Cardiovasc Thorac Surg,2017,25(1):122-124.
[18]Wang H,Hu W,Ma L,et al.Digital chest drainage system versus traditional chest drainage system after pulmonary resection:a systematic review and metaanalysis.J Cardiothorac Surg,2019,14(1): 13.

备注/Memo

备注/Memo:
基金项目:北京大学国际医院院内课题(YN2019QN09)**通讯作者,Email:liangzheng@pkuih.edu.cn
更新日期/Last Update: 2021-06-09