■尽管电视胸腔镜手术(VATS)在治疗胸部疾病中起着越来越重要的作用,在囊性包虫病中,开胸手术的作用不可替代。本研究的目的是展示VATS和传统开胸手术在西藏高原日喀则肺包虫病治疗中的应用,并比较这两种手术方法的临床安全性和有效性。
■2015年1月至2020年12月,共53例肺包虫患者接受了胸腔镜下穿刺穿刺膀胱切除术。同期接受开胸手术的126例患者作为对照组。临床特点,手术时间,围手术期并发症的发生率,逗留时间,分析VATS组和开胸手术组的住院费用,比较安全性和有效性。通过电话和门诊对患者进行随访。为了平衡潜在的混杂基线因素,采用倾向评分匹配法(PSM)建立1:1的VATS与开胸手术组的比例.
■VATS组与开胸手术组手术时间比较差异有统计学意义,失血,排水量,术后住院时间(P<0.05),VATS组优于开胸手术组。术后并发症无显著差异,不良影像学结果,或2组之间的复发率。在并发症方面,术后漏气发生率无显著差异,肺不张,或其他两组之间常见的并发症,开胸组术后发热和切口感染的发生率明显高于VATS组(P<0.05)。此外,随访3年后,两组术后复发率无显著差异.
■与传统开胸手术相比,VATS在青藏高原肺包虫病的治疗中具有可接受的疗效和安全性,可进一步加快术后恢复,降低费用。因此,应将VATS更广泛地推广到其他藏族地区。
UNASSIGNED: Although video-assisted thoracoscopic surgery (VATS) plays an increasingly significant part in treating thoracic disease, the role of thoracotomy is not replaced in cystic echinococcosis. The aim of this study was to demonstrate the application of VATS and traditional thoracotomy in the treatment of pulmonary hydatid disease in Shigatse of the Tibet Plateau and to compare the clinical safety and efficacy of these two surgical approaches.
UNASSIGNED: A total of 53 patients with pulmonary hydatid who received thoracoscopic cystectomy with needle aspiration from January 2015 to December 2020 were enrolled in the study, and 126 patients who received thoracotomy during the same period were matched as the control group. The clinical characteristics, operative time, incidence of perioperative complications, length of stay, and hospitalization cost of the VATS and thoracotomy groups were analyzed to compare the safety and efficacy. Patients were followed up through telephone and outpatient service. In order to balance potential confounding baseline factors, propensity-score matching (PSM) was applied to establish a 1:1 VATS to thoracotomy group ratio.
UNASSIGNED: There were statistically significant differences between the VATS group and the thoracotomy group in operative time, blood loss, drainage volume, and postoperative hospital stay (P<0.05), with the VATS group being superior to the thoracotomy group. There were no significant differences in postoperative complications, adverse imaging outcomes, or recurrence rates between the 2 groups. In terms of complications, there was no significant difference in the incidence of postoperative air leakage, atelectasis, or other common complications between the 2 groups, while the frequency of postoperative fever and incision infection in the thoracotomy group was significantly higher than that in the VATS group (P<0.05). Moreover, the postoperative recurrence rate between the 2 groups showed no significant difference after a 3-year follow-up.
UNASSIGNED: Compared to traditional thoracotomy, VATS had acceptable efficacy and safety and it could further accelerate postoperative recovery and reduce the cost in the treatment of pulmonary hydatid disease in the Tibetan Plateau. Thus, VATS should be promoted more widely to other Tibetan regions.