摘要
目的探讨儿童胸腔镜解剖性病灶切除术(thoracoscopic anatomic lesion resection,TALR)治疗先天性肺畸形(congenital lung malformation,CLM)的安全性与可行性。方法回顾性分析2017年10月至2022年10月在四川大学华西医院接受TALR或胸腔镜肺叶切除术(thoracoscopic lobectomy,TL)的CLM患儿419例,根据手术方式将患儿分为TALR组(205例)和TL组(214例)。对两组患儿的临床资料和随访结果进行回顾性对比分析。正态分布的计量资料采用t检验;非正态分布的计量资料采用Mann‑Whitney U检验;计数资料采用卡方检验。结果患儿均在胸腔镜下顺利完成手术,无中转开放。两组患儿的手术年龄(P=0.063)、病灶最长径(P=0.061)、术后病理结果(P=0.301)差异无统计学意义。术后两组均无支气管胸膜瘘、出血、肺不张、复发、再次手术的情况发生。TALR组的手术时间[61.4(45.0~165.0)min比48.0(38.0~125.0)min,P=0.002]、术中出血量[21.0(3.0~45.0)ml比3.5(2.0~20.0)ml,P<0.001]、留置胸引管例数(205例比29例,P<0.001)、术后住院时间[3.3(2.0~12.0)d比2.3(2.0~8.0)d,P=0.038]、术后发热例数(39例比25例,P=0.037)均多于TL组,差异均存在统计学意义。结论TALR手术安全可行,在切除病灶的同时能保留全部正常肺组织,有望成为治疗CLM的首选手术方式。
Objective To explore the safety and feasibility of thoracoscopic anatomic lesion resection(TALR)in the treatment of congenital lung malformation(CLM)in children.Methods A total of 419 children with CLM who were treated with TALR(n=205)or thoracoscopic lobectomy(TL)(n=214)in the West China Hospital of Sichuan University from October 2017 to October 2022 were retrospectively collected.Clinical data and surgical outcomes of two groups were compared.For measurement data of normal distribution,t‑test was employed;for measurement data of non‑normal distribution,Mann⁃Whitney test was performed;for counting data,the Chi‑square test was conducted.Results All children were successfully treated with thoracoscopy,without conversing to open surgery.There were no significant differences in the surgical age(P=0.063),longest lesion diameter(P=0.061)and postoperative pathological results(P=0.301)between the two groups.Major complications,including bronchopleural fistula,hemorrhage,atelectasis,recurrence or reoperation,were not reported.The operative duration[61.4(45.0‑165.0)min vs 48.0(38.0‑125.0)min,P=0.002],intraoperative bleeding volume[21.0(3.0‑45.0)ml vs 3.5(2.0‑20.0)ml,P<0.001],cases with thoracic drainage tube(205 vs 29,P<0.001),postoperative hospital stay[3.3(2.0‑12.0)days vs 2.3(2.0‑8.0)days,P=0.038],and cases with postoperative fever(39 vs 25,P=0.037)in the TALR group were significantly more than those in the TL group.Conclusions TALR is safe,feasible,and retains all normal lung tissues while removing the lesion,which is expected to become the preferable operation for the treatment of CLM.
作者
王宗禹
袁淼
程凯昇
罗登科
贾茹
刘陈宇
何涛贞
杨纲
徐畅
Wang Zongyu;Yuan Miao;Cheng Kaisheng;Luo Dengke;Jia Ru;Liu Chenyu;He Taozhen;Yang Gang;Xu Chang(Department of Pediatric Surgery,West China Hospital of Sichuan University,Chengdu 610041,China)
出处
《中华小儿外科杂志》
北大核心
2025年第7期594-597,共4页
Chinese Journal of Pediatric Surgery
基金
国家青年自然科学基金(31201095)
四川省自然科学基金(2022NSFSC0354)
四川大学华西医院学科卓越发展1·3·5工程临床研究基金(2023HXFH039)。
关键词
胸腔镜
肺叶切除术
先天性肺畸形
儿童
Thoracoscopy
Pulmonary lobectomy
Congenital lung malformation
Child
