全胸腔镜与开胸手术治疗肋骨良性肿瘤的疗效对比分析(1)
摘 要：目的 探討全胸腔镜(VATS)与开胸手术治疗肋骨良性肿瘤的疗效。方法 回顾性分析我院2013年1月～2017年7月手术治疗的38例肋骨良性肿瘤资料，按照手术方式分为开胸组20例和VATS组18例。开胸组采用传统开胸肋骨良性肿瘤切除术，VATS组采用全胸腔镜肋骨良性肿瘤切除术。比较两组患者的肿瘤直径、手术时间、术中出血、镇痛时间、术后拔引流管时间、术后住院时间、住院费用、术后并发症发生率以及随访情况。结果 与开胸组比较，VATS组术中出血少[(114±26)ml vs.(160±36)ml]，镇痛时间短[(2.7±1.1)d vs.(6.3±1.2)d]，术后拔引流管时间短[(3.5±1.3)d vs.(6.5±2.4)d]，术后住院时间短[(6.1±2.2)d vs.(11.5±2.1)d]，住院费用少[(12820.3±2350.8)元vs.(15654.5±2231.8)元]，差异具有统计学意义(P<0.05)。两组患者手术时间、肿瘤直径比较，差异无统计学意义(P>0.05)。VATS组术后并发症发生率为5.56%，低于开胸组的15.00%，差异具有统计学意义(P<0.05)。术后随访3～6个月，均无明显复发。结论 全胸腔镜手术治疗肋骨良性肿瘤较传统开胸手术创伤小、出血少、术后恢复快、疼痛轻、并发症少、费用低，患者容易接受，是一种安全可靠的手术方式，适合在临床中开展应用。
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关键词：胸腔镜;开胸手术;肋骨良性肿瘤
中图分类号：R738.1 文献标识码：B DOI：10.3969/j.issn.1006-1959.2018.16.058
文章编号：1006-1959(2018)16-0181-03
Comparison of Curative Effect between Total Thoracoscopy and Thoracotomy in the Treatment of Rib Benign Tumor
WANG Jun-feng1，DAI Yu2，FU Yu-dong1，KAN Qiang-bo1，HOU Bo1，HUANG Ruo-shan1，ZHAO Zhang-yong1，LI Ming-xue1
, 百拇医药
(1.Department of Thoracic Surgery，Qujing First People’s Hospital，Qujing 655000，Yunnan，China;
2.Qujing Medical College，Qujing 655000，Yunnan，China)
Abstract：Objective To evaluate the efficacy of total thoracoscopic(VATS)and thoracotomy in the treatment of rib benign tumors.Methods From January 2013 to July 2017，38 cases of rib benign tumors were analyzed retrospectively.According to the surgical method，the patients were divided into thoracotomy group(n=20) and VATS group(n=18).Patients in thoracotomy group were treated with traditional thoracotomy and VATS group were treated with total thoracoscopic rib benign tumor resection.The tumor diameter， operative time，intraoperative bleeding，analgesia time，postoperative drainage time，postoperative hospitalization time，hospitalization cost， postoperative complication rate and follow-up were compared between the two groups.Results Compared with thoracotomy group，VATS group had less intraoperative bleeding[(114±26)ml vs.(160±36)ml]，shorter analgesia time[(2.7±1.1)d vs.(6.3±1.2)d]，shorter postoperative drainage tube time [(3.5±1.3)d vs.(6.5±2.4) d]，shorter postoperative hospital stay[(6.1±2.2)d vs.(11.5±2.1)d]， and less hospitalization expenses[(12820.3±2350.8)yuan vs.(15654.5±2231.8)yuan]，the difference was statistically significant(P<0.05).There was no significant difference in operation time and tumor diameter between the two groups(P>0.05).The incidence of postoperative complications in VATS group was 5.56%，which was lower than that in thoracotomy group 15.00%，the difference was statistically significant(P<0.05).No recurrence was found after 3 to 6 months follow-up.Conclusion Total thoracoscopic surgery for benign rib tumors is less traumatic，less bleeding， less bleeding，faster recovery，less pain，less complications and low cost.The patient is easy to accept and it is a safe and reliable operation and suitable for clinical application., 百拇医药(王俊峰 代雨 付玉东 阚强波 侯波 黄若山 赵章勇 李明学)
, http://www.100md.com
关键词：胸腔镜;开胸手术;肋骨良性肿瘤
中图分类号：R738.1 文献标识码：B DOI：10.3969/j.issn.1006-1959.2018.16.058
文章编号：1006-1959(2018)16-0181-03
Comparison of Curative Effect between Total Thoracoscopy and Thoracotomy in the Treatment of Rib Benign Tumor
WANG Jun-feng1，DAI Yu2，FU Yu-dong1，KAN Qiang-bo1，HOU Bo1，HUANG Ruo-shan1，ZHAO Zhang-yong1，LI Ming-xue1
, 百拇医药
(1.Department of Thoracic Surgery，Qujing First People’s Hospital，Qujing 655000，Yunnan，China;
2.Qujing Medical College，Qujing 655000，Yunnan，China)
Abstract：Objective To evaluate the efficacy of total thoracoscopic(VATS)and thoracotomy in the treatment of rib benign tumors.Methods From January 2013 to July 2017，38 cases of rib benign tumors were analyzed retrospectively.According to the surgical method，the patients were divided into thoracotomy group(n=20) and VATS group(n=18).Patients in thoracotomy group were treated with traditional thoracotomy and VATS group were treated with total thoracoscopic rib benign tumor resection.The tumor diameter， operative time，intraoperative bleeding，analgesia time，postoperative drainage time，postoperative hospitalization time，hospitalization cost， postoperative complication rate and follow-up were compared between the two groups.Results Compared with thoracotomy group，VATS group had less intraoperative bleeding[(114±26)ml vs.(160±36)ml]，shorter analgesia time[(2.7±1.1)d vs.(6.3±1.2)d]，shorter postoperative drainage tube time [(3.5±1.3)d vs.(6.5±2.4) d]，shorter postoperative hospital stay[(6.1±2.2)d vs.(11.5±2.1)d]， and less hospitalization expenses[(12820.3±2350.8)yuan vs.(15654.5±2231.8)yuan]，the difference was statistically significant(P<0.05).There was no significant difference in operation time and tumor diameter between the two groups(P>0.05).The incidence of postoperative complications in VATS group was 5.56%，which was lower than that in thoracotomy group 15.00%，the difference was statistically significant(P<0.05).No recurrence was found after 3 to 6 months follow-up.Conclusion Total thoracoscopic surgery for benign rib tumors is less traumatic，less bleeding， less bleeding，faster recovery，less pain，less complications and low cost.The patient is easy to accept and it is a safe and reliable operation and suitable for clinical application., 百拇医药(王俊峰 代雨 付玉东 阚强波 侯波 黄若山 赵章勇 李明学)