胸部微创术方法研究

目的 探讨减少胸部手术切口创伤的方法。方法2001年5月～2003年7月不同时期采用不同的手术切口对120例胸外科疾病患者行外科手术,其中男67例,女53例,年龄17～79岁,平均56．6岁;肺癌41例,气胸并肺大疱7例,肺囊肿并感染1例,支气管扩张1例;食管癌69例,膈疝1例。分别采用腋下纵切口9例。前外侧切口53例,倒“L”型切口58例。结果 与传统后外侧切口相比,患者术后疼痛明显减轻,肩部及上肢活动功能明显改善,另外并发症少,瘢痕小,愈合快。结论 根据病情及局部解剖知识对手术切口进行合理设计能够减少手术创伤,有较实用的临床价值。

Clinical Use of Minimal Invasive Incision in Thoracic Surgery

Objective To study the way of how to mininize the morbidity of thoracotomy.Methods From May.2001 to July.2003,120 patients (male 67,female 53,with age of 17-79years old)underwent thoracotomies,in which 41 had lung cancer,7 pneumothorax with pulmonary bulla,1 infectious cyst of lung,1 bronchiectases,19 esophageal carcinoma and 1 diaphragmatic hernia.All of the operation were done respectively with inframammary incision(53),minimal invasive incision below axilla(9) and inversive"L"-type invasive incision(58).Results Compared with conventional posterolateral thracotomoy,the acute and chronic postoperative pain and shoulder function in study group were remarkablely improved;incisions recovered in more-short time with smaller scar and less complications.Conclusion the morbidity of thoracotomy for thoracic operations can be minimized by reasonable incision-designing based on the stage of disease and anatomy knowledge.