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冰冻肺门影响胸腔镜肺叶切除术中转开胸的分析

张兴树 余明阳 程学超 罗倩 龚明 瞿文栋 宋永祥

遵义医科大学学报2024,Vol.47Issue(4):332-337,6.
遵义医科大学学报2024,Vol.47Issue(4):332-337,6.

冰冻肺门影响胸腔镜肺叶切除术中转开胸的分析

Study and analysis the influence of frozen hilar leading to conversion to thora-cotomy during thoracoscopic lobectomy

张兴树 1余明阳 1程学超 1罗倩 1龚明 1瞿文栋 1宋永祥1

作者信息

  • 1. 遵义医科大学附属医院胸外科,贵州遵义 563000
  • 折叠

摘要

Abstract

Objective To investigate the impact of"frozen hilum"on conversion to thoracotomy during video-as-sisted thoracic surgery(VATS)lobectomy.Methods Clinical data from 733 patients who underwent VATS lo-bectomy were retrospectively analyzed.Among them,211 patients required conversion to thoracotomy due to"frozen hilum."The conversion group was further divided into an actively converted group and a passively conver-ted group based on whether the patient's life was threatened.The impact of"frozen hilum"on VATS lobectomy was analyzed.Results There were significant differences between the conversion group and the full VATS group in terms of gender,smoking history,and history of chest tuberculosis or pleurisy(P<0.05).Significant differ-ences were also found between the conversion group and the full VATS group in terms of operative duration,intr-aoperative blood loss,duration of postoperative closed chest drainage tube placement,and length of hospital stay(P<0.05).There were significant differences in postoperative complications,including subcutaneous emphyse-ma,tube reinsertion,wound infection,lung infection,atelectasis,intraoperative or postoperative blood transfu-sion,persistent air leak,and pain scores within 72 hours post operation(P<0.05).There were significant differences in operative duration,intraoperative blood loss,and length of hospital stay between the passively con-verted group and the actively converted group(P<0.05),but no significant differences were found in postoper-ative complications between the two groups(P>0.05).Conclusion"Frozen hilum"increases the difficulty and risk of lobectomy.It is an important cause of conversion to thoracotomy.Surgeons should thoroughly evaluate the presence of"frozen hilum"based on patient history and imaging data so as to develop flexible surgical plans,and be prepared for conversion to thoracotomy to reduce the incidence of perioperative complications.

关键词

冰冻肺门/胸腔镜肺叶切除术/中转开胸

Key words

Frozen hilum/thoracoscopic lobectomy/conversion to thoracotomy

分类

医药卫生

引用本文复制引用

张兴树,余明阳,程学超,罗倩,龚明,瞿文栋,宋永祥..冰冻肺门影响胸腔镜肺叶切除术中转开胸的分析[J].遵义医科大学学报,2024,47(4):332-337,6.

基金项目

国家重点研发计划项目(NO:2022YFC2407403). (NO:2022YFC2407403)

遵义医科大学学报

OACSTPCD

2096-8159

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