[1]王有钰 钱有辉** 姚达 吴昊 龚立宏 房福元.单孔胸腔镜纵隔良性肿瘤术后免胸管24例临床分析[J].中国微创外科杂志,2021,01(6):553-555.
 Wang Youyu,Qian Youhui,Yao Da,et al.Clinical Analysis of 24 Patients With Benign Mediastinal Tumor Treated With Uniportal Videoassisted Thoracoscopic Surgery Without Chest Tube Drainage[J].Chinese Journal of Minimally Invasive Surgery,2021,01(6):553-555.
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单孔胸腔镜纵隔良性肿瘤术后免胸管24例临床分析()
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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6期
页码:
553-555
栏目:
经验交流
出版日期:
2021-06-25

文章信息/Info

Title:
Clinical Analysis of 24 Patients With Benign Mediastinal Tumor Treated With Uniportal Videoassisted Thoracoscopic Surgery Without Chest Tube Drainage
作者:
王有钰 钱有辉** 姚达 吴昊 龚立宏 房福元
(深圳大学第一附属医院深圳市第二人民医院胸外科,深圳518001)
Author(s):
Wang Youyu Qian Youhui Yao Da et al.
Department of Thoracic Surgery, First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen 518001, China
关键词:
电视辅助胸腔镜手术纵隔肿瘤胸腔引流加速康复外科
Keywords:
Videoassisted thoracoscopic surgeryMediastinal tumorChest drainageEnhanced recovery after surgery
文献标志码:
B
摘要:
目的探讨单孔胸腔镜手术(videoassisted thoracoscopic surgery,VATS)治疗纵隔良性肿瘤术后免胸管的可行性。方法2019年2月~2020年9月单孔胸腔镜纵隔良性肿瘤手术44例中,根据肿瘤<6 cm、无侵犯周围组织器官、无包绕大血管或心脏、无严重胸膜腔粘连,选择24例术后不留置胸管引流。结果除1例需胸腔穿刺抽液外,其余患者在围手术期、术后第2周和第4周随访均未出现需要处理的胸腔积液及气胸。术后仅2例需使用止痛药;2例短暂心律失常,无需治疗。切口均一期愈合。结论单孔胸腔镜纵隔良性肿瘤术后免胸管对选择性的部分患者是可行的,符合加速康复外科(enhanced recovery after surgery,ERAS)理念。
Abstract:
ObjectiveTo investigate the feasibility of nonchest tube drainage after uniportal videoassisted thoracoscopic surgery (VATS) for benign mediastinal tumor.MethodsFrom February 2019 to September 2020, there were 44 cases who underwent uniportal VATS mediastinal benign tumor surgery. Among the 44 cases, 24 were selected not to be placed chest tube for drainage after surgery, according to the tumor size< 6 cm, no invasion of surrounding tissues and organs, no wrapping of large blood vessels and heart, and no severe pleural adhesion.ResultsExcept for one case requiring thoracocentesis for fluid extraction, there were no patients with pleural effusion or pneumothorax to be treated during the perioperative period, and at the second and the fourth week of followup. Only 2 cases needed painkillers after operation; 2 cases with arrhythmia did not require treatment. All incisions were primary healing.ConclusionIt is feasible for some selective patients with benign mediastinal tumor treated by uniportal VATS without indwelling chest tube after operation, which is consistent with the concept of enhanced recovery after surgery (ERAS).

参考文献/References:

[1]龚立宏,王有钰,罗伟彬,等.胸腔镜手术治疗自发性气胸术后选择性不留置胸腔闭式引流8例报告.中国微创外科杂志,2016,16(8):761-762,768.
[2]Bjerregaard LS,Jensen K,Petersen RH,et al.Early chest tube removal after videoassisted thoracic surgery lobectomy with serous fluid production up to 500 ml/day.Eur J Cardiothorac Surg,2014,45(2):241-246.
[3]黄同海,王光锁,丁光贵,等.单孔全胸腔镜手术后不置胸管治疗年轻患者自发性气胸.中国微创外科杂志,2016,16(6):535-537.
[4]Murakami J,Ueda K,Tanaka T,et al.The validation of a nodrain policy after thoracoscopic major lung resection.Ann Thorac Surg,2017,104(3):1005-1011.
[5]Miyazaki T,Nagayasu T.No drain policy for “ultimate” enhanced recovery after surgery.J Thorac Dis,2019,11(Suppl 15):S1900-S1902.
[6]Shen C,Che G.No drains in thoracic surgery with ERAS program.J Cardiothorac Surg,2020,15(1):112.
[7]Ueda K,Hayashi M,Tanaka T,et al.Omitting chest tube drainage after thoracoscopic major lung resection.Eur J Cardiothorac Surg,2013,44(2):225-229.
[8]卢礼卿,程远大,张春芳.单孔胸腔镜手术无胸管留置在胸外科快速康复中的应用.中华胸部外科电子杂志,2017,4(3):159-163.
[9]刘文汉,石文君.胸腔镜纵隔良性肿瘤切除术后不留置引流管的安全性及可行性分析.现代肿瘤医学,2020,28(21):3730-3733.
[10]王巍炜,李高峰,张勇,等.胸腔镜单操作孔切除纵隔肿瘤28例.中国微创外科杂志,2015,15(1):59-61.
[11]Li Y,Wang J.Experience of videoassisted thoracoscopic resection for posterior mediastinal neurogenic tumours:a retrospective analysis of 58 patients.ANZ J Surg,2013,83(9):664-668.

备注/Memo

备注/Memo:
基金项目:广东省卫生健康委员会项目(A2021441)**通讯作者,Email:qianyouhui888@126.com
更新日期/Last Update: 2021-08-27