电视胸腔镜围手术期并发症的回顾性分析

目的：探讨电视胸腔镜围手术（VATS）围手术期并发症原因和防治措施。方法：回顾分析374例VATS的围手术期并发症发生情况，将患者按年龄分3组，老年组（125例）、中青年组（216例）、儿童组（33例）。结果：发生围手术期并发症34例，占9．1％，其中1例死亡。中青年组织和儿童组并发症发生率分别为5．1％和3．0％，而老年组的并发症发生率为17．6％，3组之间差异有极显著意义（P＜0．01）。结论：手术者的经验和患者年龄与VATS围术期并发症的发生有关；强调循环渐进的原则可降低其发生率。

Perioperative complications after video-assisted thoracic surgery

Objective　To analyse causes of perioperative complications after video-assisted thoracic surgery and to find out measures for prevention.　Methods　Three hundred and seventy-four patients were operated on with video-assisted thoracic surgical approach. They consisted of 257 men and 117 women, aged from 9 days to 82 years(mean 47.6 years). They were divided into three groups: elderly group(≥60 years, 125 patients), middle-young group(15-59 years, 216 patients)，and children group(≤14 years, 33 patients). Under general anesthesia, 282 patients were operated on with video-thoracoscopy of two or three ports, and 92 patients with 6-8 cm mini-incision of video-assisted thoracic surgery.　Results　In 34 patients with perioperative complications (9.1%), 2 showed lung vascular bleeding during operation and one died (0.27%). The perioperative morbidity in the elderly group was significantly increased, as compared with that in the middle-young group and the children group (P＜0.01).　Conclusions　Perioperative complications of VATS are related to various factors. But the experiences in thoracoscopic manipulation of operators and the proportion of the elderly in patients are important to the perioperative morbidity. We conclude that the principles for step-by-step advancement are essential to better surgical results.