RESUMO
Objective@#To compare the effects of video assisted thoracoscopic surgery(VATS) of intercostal surgery and by subxiphoid surgical treatment for early thymoma, to investigate the feasibility and clinical application value of VATS subxiphoid surgical treatment for thymoma.@*Methods@#From January 2014 to January 2017, 30 thymoma patients who met the diagnostic criteria of the Masaoka stageⅠ~Ⅱ in the People's Hospital of Jingshan County were selected, and were divided into two groups according to the different surgical methods.The observation group (12 patients) received VATS underwent subxiphoid surgery, 18 patients in the control group were treated with VATS intercostal surgery.The operation time, blood loss, drainage time, length of stay, degree of pain, antibacterial time, incidence rate of complication and patients' satisfaction were compared between the two groups.@*Results@#The preoperative general data between the two groups had no statistically significant differences(all P>0.05). The operation time, intraoperative bleeding volume, postoperative drainage time, antibacterial time, postoperative hospitalization time in the observation group were (102.2±26.6)min, (105.9±29.4)mL, (3.8±1.4)d, (6.8±0.3)d, (8.5±1.6)d, respectively, which in the control group were (124.6±35.1)min, (255.6±82.8)mL, (5.2±1.2)d, (9.3±0.8)d, (14.4±1.8)d, respectively, there were statistically significant differences between the two groups(t=1.516, 2.517, 2.857, 4.462, 3.327, all P<0.05). The incidence rate of complications (8.33% vs.16.67%), satisfaction(82% vs.59%) between the two groups had statistically significant differences(χ2=4.013, 4.427, all P<0.05). During the follow-up period, there was no recurrence or metastasis in the two groups.@*Conclusion@#Compared with VATS intercostal surgery, VATS subxiphoid approach for surgical treatment of thymoma can reduce surgical trauma and reduce the incidence of complications, reduce the pain of patients, shorten the hospitalization time, its curative effect is more significant.
RESUMO
Objective To analyze the clinical effect of two different drainage methods after video-assisted thoracoscopic(VATS) lobectomy,and to explore the safety,reliability and practicability of clinical application of thoracic drainage tube in Department of Thoracic Surgery.Methods 1 120 cases who underwent VATS lobectomy were selected.According to different drainage methods,they were divided into two groups.560 cases in the observation group received 16-18 silicone elastic drainage,560 patients in the control group received 28-30 traditional silicone chest tube drainage.After drainage,drainage time,residual pleural fluid volume,pain score,catheter site infection rate,the incidence of pneumothorax after extubation,postoperative incidence rate of pulmonary atelectasis were compared between the two groups.Results The postoperative pleural flow of the observation group was (816 ±176) mL,which was less than (1 580 ± 204) mL of the control group,the difference was statistically significant (P =0.006).The drainage days [(5.01 ± 0.57) d],the pleural fluid volume [(2.1 ± 0.6) cm],the catheter site infection rate (0.017％),extubation pneumothorax rate (0.017％),incidence rate of postoperative atelectasis (0.16％) in the observation group were lower than those in the control group [(8.45 ± 1.24) d,(4.3 ± 0.9) cm,0.031％,0.053 ％,0.031％],the differences were statistically significant (all P ＜ 0.05).The NRS pain score between the two groups had statistically significant difference (x2 =16.24,P ＜ 0.001).Conclusion Curative effect of thin tubedrainage after VATS lung resection is safe and reliable,and can reduce the patients' postoperative pain discomfort caused by drainage tube and related complications,it is worthy of clinical popularization and application.