| ObjectiveExplore the clinical therapeutic effects with video-assisted thoracosopic surgery of two common operations, choose to provide reference for clinical lobectomy surgery.MethodsRetrospectively analyzed the clinical data of 121 lung diseases, which underwent Traditional Open Surgery(TOS), Video-assisted Minithoracotomy(VAMT) and Completely Video-assisted Thoracoscopic Surgery(c-VATS) of our hospital between January 2013 and May 2015. According to the the difference of the procedure, it can be divided into three groups. Among the cases, 34 patients underwent TOS, 39 patients used VAMT, the others were c-VATS. Contrastively analyze of the three different surgical patients with perioperative related clinical data, for example :operative time, blood loss, the time of postoperative pleural drainage tube indwelling,postoperative pain intensity grade 1,3,5 days, postoperative hospitalization, the incidence of complications, etc. Comparison between the two groups using t test,using the ? 2 test for categorical data analysis. Application SPSS17.0 statistical software for data analysis, P < 0.05 show that difference was statistically significant,P < 0.001 showed significant differences. Comparison between the indexes by correlation analysis.ResultsAll the operations successful, patients were cured and discharged, no operative deaths. There was no statistical significance difference in three groups of patients’ age,gender, lesion site,(P>0.05).TOS: the operation time was 228.82±19.23 min, intraoperative blood loss was387.73±101.88 ml. Postoperative thoracic cavity closed drainage tube indwelling time was 7.82±1.65 d, postoperative pain intensity grade 1,3, 5 days were 6.08±0.80 points,6.08±0.68 points, 4.95±0.80 points, postoperative hospital stay was 13.55±2.11 d.Postoperative complications: 2 case of lung infection, atelectasis, 1 case, 1 cases of arrhythmia, lung pulmonary infection, 1 case of leak, incidence of complications was14.70%.VAMT: the operation time was 198.00±29.51 min, intraoperative blood loss was241.33±41.73 ml. Postoperative thoracic cavity closed drainage tube indwelling time was 4.87±1.36 d, postoperative pain intensity grade 1, 3, 5 days were 5.18±0.81 points, 5.18±0.77 points, 3.86±0.62 points, postoperative hospital stay was10.27±2.40 d. 1 case of lung infection, pulmonary continued leak in 1 case, incidence of complications was 5.15%.C-VATS: the operation time was 182.50±20.34 min, intraoperative blood loss was 193.24±70.74 ml. Postoperative thoracic cavity closed drainage tube indwelling time was 3.62±1.67 d, postoperative pain intensity grade 1, 3, 5 days were4.00±0.90 points, 4.00±0.63 points, 3.26 0.60 mm, postoperative hospital stay was10.21±2.71 d. Only 2 cases with pulmonary and cardiac arrhythmia, pulmonary infection, infection of incision, and shoulder joint activities obstacles. Complication rate was 4.17%.There are statistical significant difference to compare VAMT with TOS: the difference was statistically significant in operation time, intraoperative blood loss,postoperative chest cavity closed type drainage tube indwelling time, postoperative pain intensity grade 1, 3, 5 days and postoperative hospital stays, the incidence of complications(P<0.05).C-VATS compared with TOS: the difference was statistically significant on intraoperative blood loss, postoperative chest cavity closed type drainage tube indwelling time, postoperative pain intensity grade 1, 3, 5 days and postoperative hospital stays(P<0.05), there was significant difference in the operation time(P<0.001). C-VATS compared with VAMT: the difference was statistically significant on operation time, intraoperative blood loss, postoperative chest cavity closed type drainage tube indwelling time, postoperative pain intensity grade 1, 3, 5days(P<0.05). There was no statistically significant difference in postoperative hospital stays and the incidence of complications(P=0.242).Conclusions1.Compared with the traditional thoracotomy, Video-assisted thoracoscopic surgery lobectomy has small trauma, less blood loss, shorter hospitalization time, etc2.The curative effect is reliable, when we use completely video-assisted thoracoscopic surgery lobectomy, not only that,it is worth popularizing because of it’s more minimally invasive, beautiful sex, quicker recovery of patients, and the complications incidence is low. |
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