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目的分析全胸腔镜肺癌切除术中转开胸的原因。方法肺癌患者127例,均行全胸腔镜肺癌切除术,比较中转开胸与未中转患者围手术期相关指标及术后并发症情况。结果127例患者均顺利完成手术,中转开胸25例,其中淋巴结干扰20例,大出血5例,发生率19.69%(25/127);中转开胸患者手术时间(269.32±63.47)分钟,引流管留置时间(9.15±2.74)天,住院时间(12.01±2.56)天,未中转患者分别为(175.49±43.16)分钟、(4.08±1.62)天、(7.45±1.08)天,两组比较差异有统计学意义(P<0.01);中转开胸与未中转患者术后切口感染、肺感染、肺不张、心律失常的发生率比较,差异无统计学意义意义(P>0.05)。结论行全胸腔镜肺癌切除术治疗的患者,由于淋巴结干扰中转开胸,中转开胸导致手术时间延长,出血量增大,创伤增大,但未增加术后并发症发生的风险。
Objective To analyze the reasons of thoracoscopic lung cancer resection and thoracotomy. Methods A total of 127 patients with lung cancer undergoing thoracoscopic lung resection were enrolled in this study. Perioperative indexes and postoperative complications were compared between patients undergoing open thoracotomy and without conversion. Results Of the 127 patients, 25 cases were successfully transferred to the thoracotomy, including 20 cases of lymphadenopathy and 5 cases of hemorrhage. The incidence rate was 19.69% (25/127). The time of operation was (269.32 ± 63.47) minutes and the drainage tube The days of stay (9.15 ± 2.74) and hospital stay (12.01 ± 2.56) days were (175.49 ± 43.16) days, (4.08 ± 1.62) days and (7.45 ± 1.08) days, respectively (P <0.01). There was no significant difference in incision infection, pulmonary infection, atelectasis and arrhythmia between patients undergoing transcatheter transfer and without transcatheter transfer (P> 0.05). Conclusions Patients undergoing total thoracoscopic lung cancer resection have a prolonged operative time, increased bleeding and increased trauma because of lymphatic metastasis and thoracotomy. However, the risk of postoperative complications is not increased.