Volume 20 Issue 2
Feb.  2022
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ZHANG Lei, LI Xiao-jun, GONG Hui-yuan, WANG Biao. Clinical analysis of safety and reduce consumables of thoracoscopic pulmonary segmentectomy[J]. Chinese Journal of General Practice, 2022, 20(2): 206-208, 331. doi: 10.16766/j.cnki.issn.1674-4152.002313
Citation: ZHANG Lei, LI Xiao-jun, GONG Hui-yuan, WANG Biao. Clinical analysis of safety and reduce consumables of thoracoscopic pulmonary segmentectomy[J]. Chinese Journal of General Practice, 2022, 20(2): 206-208, 331. doi: 10.16766/j.cnki.issn.1674-4152.002313

Clinical analysis of safety and reduce consumables of thoracoscopic pulmonary segmentectomy

doi: 10.16766/j.cnki.issn.1674-4152.002313
Funds:

 KJ2019A0340

 BYTM2019031

 BYTM2019016

 BYKF1864

 2019117

 2020128

  • Received Date: 2021-02-08
    Available Online: 2022-03-04
  •   Objective  To discuss the effect of the operation mode of controlling the use of high-value consumables on the safety and efficacy of thoracoscopic pulmonary segmentectomy.  Methods  A retrospective analysis of 33 patients who had thoracoscopic pulmonary segmentectomy in the Thoracic Surgery Department of the First Affiliated Hospital of Bengbu Medical College from December 2018 to December 2019 was conducted. The patients included 6 males and 27 females, with an age range of 31-75 years and an average age of (55.33±10.25) years. Depending on their lesions, the patients were subjected to single pulmonary segment resection, combined pulmonary segment resection or pulmonary segment+wedge resection. The veins between segments were retained by treating the pulmonary arteries and veins with ligation. The intersegmental boundary was confirmed using the expansion and collapse method, the target pulmonary segment was separated from the target centre to the periphery with the energy instruments. The remaining intersegmental plane was cut with the cutting and stitching instrument. The pulmonary wedge was resected with the clamp and stitched after resection. The cost of surgical consumables was controlled through individualised methods, whereas the operation safety and efficacy were ensured.  Results  Operation was successfully completed for the 33 patients, which was in line with the pre-operative plan. Of the 33 patients, 14 underwent single pulmonary segment resection, 11 underwent combined pulmonary segment resection and 8 underwent pulmonary segment + wedge resection; 42 lesions were resected. The use of consumables for pulmonary vascular resection, wedge resection and intersegmental plane treatment was reduced. No apparent air leakage and haemorrhage were observed at the intersegmental plane treated with energy instruments, and no apparent pressing was found at the intersegmental plane treated with the cutting and stitching instrument. The post-operative pulmonary expansion was satisfactory, with a total drainage volume of 100-2 330 mL, an indwelling time of chest drainage tube of 2-18 days and a post-operative LOS of 4-18 days. No serious complication occurred after operation, and 6 patients with slight air leakage were recovered after drainage.  Conclusion  Thoracoscopic pulmonary segmentectomy can ensure the operation safety, economy and short-term efficacy by the operation mode of controlling the use of surgical consumables, which is conducive to the promotion of the operation.

     

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  • [1]
    宋勇, 袁冬梅. 肺部结节处理中的几点思考[J]. 中华医学杂志, 2019, 99(2): 81-83. doi: 10.3760/cma.j.issn.0376-2491.2019.02.001
    [2]
    王群, 蒋伟, 奚俊杰. 肺部多发磨玻璃影的外科治疗[J]. 中国肺癌杂志, 2016, 19(6): 355-358. https://www.cnki.com.cn/Article/CJFDTOTAL-FAIZ201606013.htm
    [3]
    陈海, 刘亮亮, 于在诚. 新技术在肺段切除术术前规划的应用进展[J]. 安徽医学, 2020, 41(8): 976-979. doi: 10.3969/j.issn.1000-0399.2020.08.031
    [4]
    陈亮, 王俊, 吴卫兵, 等. 胸腔镜精准肺段切除术技术流程和质量控制[J]. 中国胸心血管外科临床杂志, 2019, 26(1): 21-28. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXYX201901004.htm
    [5]
    隋天一, 刘傲, 矫文捷. 肺段切除术与肺叶切除术术后肺功能保留的差异[J]. 中国肺癌杂志, 2019, 22(3): 178-182. https://www.cnki.com.cn/Article/CJFDTOTAL-FAIZ201903012.htm
    [6]
    PHD B B M F, ME F J, PHD S M M I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2018, 68(6): 394-424. doi: 10.3322/caac.21492
    [7]
    HENG R S, SUN K X, ZHANG S W, et al. Report of cancer epidemiology in China, 2015[J]. Chin J Oncol, 2019, 41(1): 19-28.
    [8]
    陈亮, 吴卫兵. 胸腔镜解剖性肺段切除术技术要点[J]. 中国肺癌杂志, 2016, 19(6): 377-381. https://www.cnki.com.cn/Article/CJFDTOTAL-FAIZ201606018.htm
    [9]
    吴卫兵, 朱全, 闻伟, 等. 应用改良膨胀萎陷法行胸腔镜锥式肺段切除术146例[J]. 中华胸心血管外科杂志, 2017, 33(9): 517-521. doi: 10.3760/cma.j.issn.1001-4497.2017.09.002
    [10]
    张树亮, 郑斌, 徐国兵, 等. 联合降维法在达芬奇机器人辅助精准肺段切除术中的应用[J]. 中华胸部外科电子杂志, 2019, 6(2): 139-140. doi: 10.3877/cma.j.issn.2095-8773.2019.02.12
    [11]
    KURODA H, DEJIMA H, MIZUMO T, et al. A new LigaSure technique for the formation of segmental plane by intravenous indocyanine green fluorescence during thoracoscopic anatomical segmentectomy[J]. J Thorac Dis, 2016, 8(6): 1210-1216. doi: 10.21037/jtd.2016.04.61
    [12]
    WU W B, XIA Y, PAN X L, et al. Three-dimensional navigation-guided thoracoscopic combined subsegmentectomy for intersegmental pulmonary nodules[J]. Thorac Cancer, 2019, 10(2): 41-46.
    [13]
    孙超, 陆世春, 王霄霖, 等. 三维重建技术在胸腔镜解剖性肺段切除术中的应用[J]. 中国微创外科杂志, 2019, 19(2): 115-117. doi: 10.3969/j.issn.1009-6604.2019.02.005
    [14]
    李小军, 朱潇, 杏福宝, 等. 三维重建及3D打印在微创肺外科中的应用[J]. 中华全科医学, 2020, 18(7): 1190-1194. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY202007035.htm
    [15]
    吕静, 文智, 孙小康, 等. 市级医院环境下早期肺癌全胸腔镜肺叶切除的学习曲线探索[J]. 西南军医, 2018, 20(4): 459-462. doi: 10.3969/j.issn.1672-7193.2018.04.018
    [16]
    杨德松, 王文祥, 周勇, 等. 全胸腔镜袖式肺叶切除治疗中央型肺癌的学习曲线[J]. 中华胸心血管外科杂志, 2019, 35(7): 385-389. doi: 10.3760/cma.j.issn.1001-4497.2019.07.001
    [17]
    马永富, 姚洁, 陈瑞骥, 等. 术前3D重建、术中CT定位荧光胸腔镜下右肺下叶外后基底段精准切除术[J/CD]. 中华腔镜外科杂志(电子版), 2018, 11(3): 180-182. doi: 10.3877/cma.j.issn.1674-6899.2018.03.018
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