胸腔鏡微創術后不留置胸腔引流管在快速康復外科中的應用_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

葉雄 ,  陳剛 , 唐繼鳴 , 謝亮 , 賁曉松 , 章瀚文 , 林文梁

廣東省人民醫院廣東省醫學科學院胸外科，廣州 510080;

Corresponding?author：

陳剛, Email: chenganggz@aliyun.com

Keywords：

快速康復外科; 微創手術; 胸腔鏡; 胸腔閉式引流

DOI：

10.7507/1007-4848.20140030

Video：

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目的探討患者接受胸腔鏡微創手術后不留置胸腔引流管的安全性和可行性。方法回顧性分析2013年1～9月廣東省人民醫院胸外科20例行胸腔鏡微創手術后不留置胸腔引流管患者的臨床資料，其中男14例、女6例，年齡36.7（17～68）歲，分析患者術后恢復情況。結果全組20例患者均順利完成手術，無圍手術期死亡，無二次手術；術后均未出現嚴重并發癥，均不需有創性操作；術后平均住院時間3.5 d，出院后1周復查胸部X線片均無異常。結論部分患者接受胸腔鏡微創手術后不留置胸腔引流管是安全可行的，符合快速康復外科理念。

Citation： 葉雄, 陳剛, 唐繼鳴, 謝亮, 賁曉松, 章瀚文, 林文梁. 胸腔鏡微創術后不留置胸腔引流管在快速康復外科中的應用. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(1): 112-114. doi: 10.7507/1007-4848.20140030 Copy

1.	Wilmore DW, Kehlet H.Management of patients in fast track surgery BMJ, 2001, 322 (7284):473-476.
2.	Kehlet H, Wilmore DW.Multimodal strategies to improve surgical outcome.Am J Surg, 2002, 183 (6):630-641.
3.	江志偉, 李寧, 黎介壽.快速康復外科的概念及臨床意義.中國實用外科雜志, 2007, 27 (2):131-133.
4.	劉倫旭.開胸手術將逐漸"升級"為胸腔鏡微創手術的補充.中國胸心血管外科臨床, 2012, 19 (2):109-112.
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7.	Boffa DJ, Kosinski AS, Paul S, et al.Lymph node evaluation by open or video-assisted approaches in 11, 500 anatomic lung cancer resections.Ann Thorac Surg, 2012, 94 (2):347-353.
8.	李運, 王俊, 隋錫朝, 等.全胸腔鏡肺葉切除手術操作流程及技巧的優化:北京大學人民醫院經驗.中華胸心血管外科雜志, 2010, 26 (5):300-306.
9.	Swanson SJ, Meyers BF, Gunnarsson CL, et al.Video-assisted thoracoscopic lobectomy is less costly and morbid than open lobectomy:a retrospective multiinstitutional database analysis.Ann Thorac Surg, 2012, 93 (4):1027-1032.
10.	段善州, 陳勇兵, 楊文濤, 等.全胸腔鏡治療肺部良性疾病術后置與不置胸管的效果.江蘇醫藥, 2012, 38 (3):335-337.
11.	朱雪娟.胸腔鏡肺部良性疾病術后不置胸管的圍手術期護理配合.臨床肺科雜志, 2012, 17 (12):2326-2326.
12.	趙國強, 高新芳, 鄒芳.改良胸腹聯合切口賁門癌術后不放置胸腔閉式引流管106例臨床分析.中國現代醫學雜志, 2005, 15 (3):440-441, 444.
13.	Ueda K, Hayashi M, Tanaka T, et al.Omitting chest tube drainage after thoracoscopic major lung resection.Eur J Cardiothorac Surg, 2013, 44 (2):225-229.
14.	Refai M, Brunelli A, Salati M, et al.The impact of chest tube removal on pain and pulmonary function after pulmonary resection.Eur J Cardiothorac Surg, 2012, 41 (4):820-822.
15.	Padilla Alarcón J, Pe?alver Cuesta JC.Experience with lung resection in a fast-track surgery program.Arch Bronconeumol, 2013, 49 (3):89-93.
16.	Zhao G, Huang Y, Chen X, et al.Research on fast track surgery application in lung cancer surgery.Zhongguo Fei Ai Za Zhi, 2010, 13 (2):102-106.
17.	Wehberg KE, Jackson D, Walters J, et al.Fast track minimally invasive transmyocardial revascularization.Innovations (Phila), 2009, 4 (4):217-220.

1. Wilmore DW, Kehlet H.Management of patients in fast track surgery BMJ, 2001, 322 (7284):473-476.
2. Kehlet H, Wilmore DW.Multimodal strategies to improve surgical outcome.Am J Surg, 2002, 183 (6):630-641.
3. 江志偉, 李寧, 黎介壽.快速康復外科的概念及臨床意義.中國實用外科雜志, 2007, 27 (2):131-133.
4. 劉倫旭.開胸手術將逐漸"升級"為胸腔鏡微創手術的補充.中國胸心血管外科臨床, 2012, 19 (2):109-112.
5. Takagi H, Matsui M, Umemoto T.Long-term survival of VATS versus open lobectomy.Ann Thorac Surg, 2011, 92 (1):408-409.
6. Papiashvilli M, Stav D, Cyjon A, et al.Lobectomy for non-small cell lung Cancer:differences in morbidity and mortality between thoracotomy and thoracoscopy.Innovations (Phila), 2012, 7 (1):15-22.
7. Boffa DJ, Kosinski AS, Paul S, et al.Lymph node evaluation by open or video-assisted approaches in 11, 500 anatomic lung cancer resections.Ann Thorac Surg, 2012, 94 (2):347-353.
8. 李運, 王俊, 隋錫朝, 等.全胸腔鏡肺葉切除手術操作流程及技巧的優化:北京大學人民醫院經驗.中華胸心血管外科雜志, 2010, 26 (5):300-306.
9. Swanson SJ, Meyers BF, Gunnarsson CL, et al.Video-assisted thoracoscopic lobectomy is less costly and morbid than open lobectomy:a retrospective multiinstitutional database analysis.Ann Thorac Surg, 2012, 93 (4):1027-1032.
10. 段善州, 陳勇兵, 楊文濤, 等.全胸腔鏡治療肺部良性疾病術后置與不置胸管的效果.江蘇醫藥, 2012, 38 (3):335-337.
11. 朱雪娟.胸腔鏡肺部良性疾病術后不置胸管的圍手術期護理配合.臨床肺科雜志, 2012, 17 (12):2326-2326.
12. 趙國強, 高新芳, 鄒芳.改良胸腹聯合切口賁門癌術后不放置胸腔閉式引流管106例臨床分析.中國現代醫學雜志, 2005, 15 (3):440-441, 444.
13. Ueda K, Hayashi M, Tanaka T, et al.Omitting chest tube drainage after thoracoscopic major lung resection.Eur J Cardiothorac Surg, 2013, 44 (2):225-229.
14. Refai M, Brunelli A, Salati M, et al.The impact of chest tube removal on pain and pulmonary function after pulmonary resection.Eur J Cardiothorac Surg, 2012, 41 (4):820-822.
15. Padilla Alarcón J, Pe?alver Cuesta JC.Experience with lung resection in a fast-track surgery program.Arch Bronconeumol, 2013, 49 (3):89-93.
16. Zhao G, Huang Y, Chen X, et al.Research on fast track surgery application in lung cancer surgery.Zhongguo Fei Ai Za Zhi, 2010, 13 (2):102-106.
17. Wehberg KE, Jackson D, Walters J, et al.Fast track minimally invasive transmyocardial revascularization.Innovations (Phila), 2009, 4 (4):217-220.

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胸腔鏡微創術后不留置胸腔引流管在快速康復外科中的應用

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