Clinical Comparison Of Complete Thoracoscopic Lobectomy With Conventional Thoracotomy Lobectomy

Objective:Complete video-assisted thoracoscopic lobetomy surgery was a minimally invasive treatment technology of lung diseases.Through retrospective analysis of patients with cVATS in our hospital. safety and efficacy of cVATS was compared with traditional thoracotomy lobectomy. and then, the several issues that appeared in perioperative period were analyzed.Methods:In our hospital,100patients with pulmonary lobectomy wered selected from March2008to March2014.In accordance with the conditions of selection and principle of randomization, the final selection of60patients were randomly divided into two groups,cVATS group and thoracotomy group. cVATS group included18males and12females, aged30to68years (50.00±9.57years), and the group underwent cVATS; thoracotomy group included20males and10females, aged34to69years (50.00±9.96years), and the group underwent traditional thoracotomy The pathological diagnosis,general state of health (postoperative pain, number of intraoperative use of Endoscopic stapler, hospital cost, length of stay, blood loss, postoperative complication rate) and complication (arrhythmia, infection,.)would be observed.The results:In cVATS group2cases transfered thoracotomy lobectomy, but all patients were safely discharged from hospital. Blood loss:cVATS group148.07±12.07ml, thoracotomy group382.06±39.57ml, compared with thoracotomy group, VATS group bleeding was less,and there was a significant difference (P<0.05); level of postoperative pain:cVATS group (first day)4.00±0.82, thoracotomy group (first day)6.37±0.89, statistical analysis between groups, P<0.05; cVATS group (third day)3.86±0.71, thoracotomy group (third day)6.00±0.69, statistical analysis between groups, P<0.05; cVATS group (fifth day)2.96±0.79, thoracotomy group (fifth day)4.90±0.92. statistical analysis between groups, P<0.05;number of intraoperative use of Endoscopic stapler:cVATS group6.29±1.12个,thoracotomy group4.20±0.66个, statistical analysis between groups, P<0.05; hospital stay cVATS group9.79±0.88days,thoracotomy group12.13±1.40days, statistical analysis between groups, P<0.05; hospitalization costs:cVATS group37065.79±3534.64yuan, the thoracotomy group32799.37±3961.72yuan, statistical analysis between groups, P<0.05; complication rates:in cVATS group,1patients occurred arrhythmia, and in thoracotomy group.4cases of arrhythmia,4cases of lung infection arised, statistical analysis between groups, P<0.05.Conclusion:1.cVATS is a safe and effective surgical method that can significantly reduce blood loss, and reduce complications.2.In conjunction with systemic management in perioperative period, patients recover faster than traditional surgical procedures.3.Although it is more expensive than traditional surgery’s, to a certain extent its application limited, the quick postoperative rehabilitation makes up for this shortcoming to some extent.4. As long as to grasp the attitude of cautious, responsiblity and seriousness in every patient, every surgery, relying on close collaboration with the team, all surgery patients can get benefit who have indications of cVATS.If the indications of surgery is strickly managed, and abundant theoretical knowledge and practical skills is mastered, cVATS can be popularize in second or tertiary hospitals.