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目的探讨腋下小切口在原发性肺癌手术中的应用前景。方法将2001年1月—2008年6月手术治疗肺癌患者338例,分成两组,试验组:158例采用腋下小切口手术;对照组:180例采用传统的后外侧切口,将两组进行随机临床对照试验。结果患者术前状况基本一致的条件下,两组切口长度(10.61±1.29)cm、(26.50±4.96)cm;手术时间(120.42±30.10)min、(158.31±28.01)min;术中出血量(190.05±78.65)ml、(250.10±110.23)ml;术后引流量(420.16±120)ml、(510.30±151.20)ml;术后住院天数(10.89±4.49)d、(14.65±3.55)d,经统计学处理,试验组和对照组之间的差异均有统计学意义(P<0.001),术后试验组肩关节活动障碍等并发症的发生率均较对照组低,两组比较差异有统计学意义(P<0.05),平均清扫淋巴结(14.31±5.98)枚、(15.12±6.27)枚,两组之间差异无统计学意义(P>0.05)。结论腋下小切口是一种操作简单、术中显露良好、胸壁损伤轻、出血少、术后并发症少、功能恢复好、手术时间及住院时间短、切口隐蔽而美观的术式,对绝大部分肺癌行根治性手术可行,基本不影响手术操作及淋巴结清扫范围,值得进一步推广应用。
Objective To explore the application of axillary small incision in the surgical treatment of primary lung cancer. Methods From January 2001 to June 2008, 338 patients with lung cancer surgically treated were divided into two groups. In the experimental group, 158 cases were treated with small incision of the armpit. In the control group, 180 cases were treated with the conventional posterolateral incision and the two groups were performed Randomized controlled clinical trial. Results The average length of incision was (10.61 ± 1.29) cm, (26.50 ± 4.96) cm in operation and 120.42 ± 30.10 min in operation (158.31 ± 28.01) min respectively. The intraoperative blood loss ( 190.05 ± 78.65) ml and (250.10 ± 110.23) ml respectively. The amount of postoperative drainage was (420.16 ± 120) ml and (510.30 ± 151.20) ml respectively. The length of postoperative hospital stay was (10.89 ± 4.49) days and (14.65 ± 3.55) Statistical analysis, the difference between the experimental group and the control group were statistically significant (P <0.001), the incidence of postoperative complications such as shoulder joint movement disorders were lower than the control group, the difference between the two groups statistics There was no significant difference between the two groups (P> 0.05). The average lymph node count (14.31 ± 5.98) and (15.12 ± 6.27) were statistically significant (P> 0.05). Conclusions The underarm incision is a kind of operation that is easy to operate, good in operation, light in chest wall, less bleeding, less postoperative complications, good function recovery, short operation time and hospitalization, hidden and beautiful incision Most of the radical surgery of lung cancer feasible, does not affect the basic surgical operation and lymph node dissection range, it is worth further promotion and application.