视频辅助胸腔镜手术细分切除术的难度:提出一个新的分类
Fei Yao1,2, Weibing Wu1, Quan Zhu1
1Department I of Thoracic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Annals of surgical oncology
|June 12, 2023
概括
视频辅助胸腔镜手术 (VATS) 分段切除术的新三级分类准确地预测了手术难度. 该系统改进了用于分类VATS分段切除的简单/复杂方法.
科学领域:
- 胸部外科手术 胸部外科手术
- 手术瘤学手术瘤学
- 最少侵入性手术的方法
背景情况:
- 基于分段间平面 (ISP) 的传统的"简单"与"复杂"分段解剖分类是不够的.
- 视频辅助胸腔镜手术 (VATS) 分段切除术的复杂性日益增加,需要改进的分类系统.
研究的目的:
- 开发和验证一种新的分类系统,用于预测VATS细分切除术的手术难度.
- 改进VATS分段切除的风险分层和操作规划.
主要方法:
- 对1868个VATS细分切除病例 (2014-2019) 的回顾性审查.
- 单变量和多变量分析以确定延长操作时间 (>140分钟) 的预测因素.
- 构建一个新的评分系统来分类手术难度.
主要成果:
- 基于ISP剖析和分段切除,建立了一个新的三级分类 (低难度,中难度,高难度).
- 新的分类根据手术时间,血液损失和并发症率 (p < 0.001) 显著区分了这些组.
- 与简单/复杂分类相比,接收器操作特征分析证实了优越的预测性能.
结论:
- 开发的三级分类准确地预测了VATS分段切除术中的手术困难.
- 该系统为胸部外科医生提供了改进的风险评估和手术规划.
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