经乳晕隐痕切口在胸外科男性患者微创手术中的应用

 目的 探讨经乳晕隐痕切口在胸外科男性患者微创胸腔镜手术中的可行性和优势。方法 回顾性分析2016-03至2019-01武警海警总队医院胸心外科收治的单孔胸腔镜手术男性患者资料,其中56例经乳晕切口(乳晕组),68例常规切口(对照组)。比较两组患者手术时间、术中出血量、术后胸腔引流量、拔管时间、术后住院天数、术后第1天和第2天的视觉模拟评分,以及术后1、3个月切口不适情况、远期切口满意度等。结果 所有患者均顺利完成手术,术中术后均未出现严重并发症。两组在手术时间、术中出血量、术后胸腔引流液量、拔除胸管时间、术后住院天数、术后第1天VAS评分等方面差异无统计学意义,与对照组相比,乳晕组的术后第2天VAS评分下降明显(P＜0.05),切口不适人数减少,差异有统计学意义(P＜0.05)。术后6个月随访乳晕组对瘢痕非常满意者有41例(73.2%),对照组有19例(27.9%),两组瘢痕满意度比较,差异有统计学意义(P＜0.05)。结论 在部分胸部疾病中,男性患者选择经乳晕切口行单孔胸腔镜手术是安全、可行的,可以提高切口满意度,更能体现出微创无瘢痕这一特点,值得临床推广。

Applicability of incision through areola in minimally invasive surgery for male patients during thoracic surgery

Objective To investigate the feasibility and advantages of minimally invasive video-assisted thoracoscopic surgery through areola incision among male thoracic surgery patients.Methods The data about male patients undergoing single-port video-assisted thoracoscopic surgery in the Department of Chest and Heart Surgery, the Hospital of Armed Police Coast Guard, between March 2016 and January 2019 was retrospectively analyzed. Fifty-six cases were treated with areola incision (areola group), and 68 with conventional incision (control group). The duration of surgery, intraoperative bleeding volume, postoperative thoracic drainage volume, extubation time, postoperative hospital stay, visual simulation scores one and two days after operation, the number of uncomfortable incisions one and three months after operation, and the levels of satisfaction with long-term incisions were compared between the two groups.Results All patients smoothly completed surgery without serious complications intraoperatively or postoperativley. There was no significant difference between the two groups in the duration of surgery, intraoperative bleeding volume, postoperative thoracic drainage volume, extubation time, postoperative hospital stay, or VAS scores one day after operation. Compared with the control group, the VAS score on the second postoperative day in the areola group was decreased (P<0.05), and there were fewer patients with incision discomfort (P<0.05). Forty-one cases (73.2%) in the areola group and 19 cases (27.9%) in the control group were followed up for half a year. The difference in levels of satisfaction with incisions was statistically significant between the two groups (P<0.05).Conclusions The areola incision for single-hole video-assisted thoracoscopic surgery is safe and feasible for male patients with thoracopathy, which can leave incisions more satisfactory and scar-free, so this approach should be made more accessible.