胸腔镜微创术后不留置胸腔引流管在快速康复外科中的应用_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

叶雄 ,  陈刚 , 唐继鸣 , 谢亮 , 贲晓松 , 章瀚文 , 林文梁

广东省人民医院广东省医学科学院胸外科，广州 510080;

Corresponding author：

陈刚, Email: chenganggz@aliyun.com

Keywords：

快速康复外科; 微创手术; 胸腔镜; 胸腔闭式引流

DOI：

10.7507/1007-4848.20140030

Video：

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目的探讨患者接受胸腔镜微创手术后不留置胸腔引流管的安全性和可行性。方法回顾性分析2013年1～9月广东省人民医院胸外科20例行胸腔镜微创手术后不留置胸腔引流管患者的临床资料，其中男14例、女6例，年龄36.7（17～68）岁，分析患者术后恢复情况。结果全组20例患者均顺利完成手术，无围手术期死亡，无二次手术；术后均未出现严重并发症，均不需有创性操作；术后平均住院时间3.5 d，出院后1周复查胸部X线片均无异常。结论部分患者接受胸腔镜微创手术后不留置胸腔引流管是安全可行的，符合快速康复外科理念。

Citation： 叶雄, 陈刚, 唐继鸣, 谢亮, 贲晓松, 章瀚文, 林文梁. 胸腔镜微创术后不留置胸腔引流管在快速康复外科中的应用. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(1): 112-114. doi: 10.7507/1007-4848.20140030 Copy

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2.	Kehlet H, Wilmore DW.Multimodal strategies to improve surgical outcome.Am J Surg, 2002, 183 (6):630-641.
3.	江志伟, 李宁, 黎介寿.快速康复外科的概念及临床意义.中国实用外科杂志, 2007, 27 (2):131-133.
4.	刘伦旭.开胸手术将逐渐"升级"为胸腔镜微创手术的补充.中国胸心血管外科临床, 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.	李运, 王俊, 隋锡朝, 等.全胸腔镜肺叶切除手术操作流程及技巧的优化:北京大学人民医院经验.中华胸心血管外科杂志, 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, 陈勇兵, 杨文涛, 等.全胸腔镜治疗肺部良性疾病术后置与不置胸管的效果.江苏医药, 2012, 38 (3):335-337.
11.	朱雪娟.胸腔镜肺部良性疾病术后不置胸管的围手术期护理配合.临床肺科杂志, 2012, 17 (12):2326-2326.
12.	赵国强, 高新芳, 邹芳.改良胸腹联合切口贲门癌术后不放置胸腔闭式引流管106例临床分析.中国现代医学杂志, 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, Peñalver 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. 江志伟, 李宁, 黎介寿.快速康复外科的概念及临床意义.中国实用外科杂志, 2007, 27 (2):131-133.
4. 刘伦旭.开胸手术将逐渐"升级"为胸腔镜微创手术的补充.中国胸心血管外科临床, 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. 李运, 王俊, 隋锡朝, 等.全胸腔镜肺叶切除手术操作流程及技巧的优化:北京大学人民医院经验.中华胸心血管外科杂志, 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, 陈勇兵, 杨文涛, 等.全胸腔镜治疗肺部良性疾病术后置与不置胸管的效果.江苏医药, 2012, 38 (3):335-337.
11. 朱雪娟.胸腔镜肺部良性疾病术后不置胸管的围手术期护理配合.临床肺科杂志, 2012, 17 (12):2326-2326.
12. 赵国强, 高新芳, 邹芳.改良胸腹联合切口贲门癌术后不放置胸腔闭式引流管106例临床分析.中国现代医学杂志, 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, Peñalver 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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胸腔镜微创术后不留置胸腔引流管在快速康复外科中的应用

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