Video-assisted thoracoscopic versus conventional surgery in internal fixation of multiple rib fractures
10.3760/cma.j.issn.1671-0282.2020.09.014
- VernacularTitle:胸腔镜辅助肋骨固定与传统手术病例对照研究
- Author:
Yuanbo ZHONG
1
;
Jin WANG
;
Shihai XU
;
Aijun SHAN
;
Liangong LONG
;
Bo DU
;
Chao YANG
;
Wen LYU
;
Jianzhong XU
;
Xianliang ZHONG
Author Information
1. 深圳市人民医院（暨南大学第二临床医学院，南方科技大学第一附属医院）急诊医学科 518020
- From:
Chinese Journal of Emergency Medicine
2020;29(9):1214-1218
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the effects between video-assisted thoracoscopic surgery (VATS) and conventional surgery in internal fixation of multiple rib fractures.Methods:Patients with multiple rib fractures, who were admitted to Emergency Center of Shenzhen People's Hospital from June 2010 to May 2020, were included. Patients were divided into the VATS group (incision positioning with VATS) and the conventional group (incisionpositioning with CT scan). The primary outcome measures was the risk of complications, and the secondary outcome measures included postoperative pain, incision length, operation time, and mechanical ventilation rate. Continuous and categorical variables were compared using LSD- t test and Chi-square test. Repeated measures analysis of variance was performed to assess the trend of postoperative pain over time. A logistic regression analysis was used to explore the association of VATS with postoperative complications. Results:A total of 221 patients, including 128 patients in the VATS group and 93 patitents in the conventional group, were enrolled. Baseline characteristics were identical between the two groups ( P>0.05). In the VATS group, the length of incision, intraoperative blood loss, operation time, mechanical ventilation rate after operation, ventilation time, thoracic tube indwelling time, ICU and total length of stay, and medical costs were better than those in the conventional group (all P<0.05). Repeated measures analysis of variance showed that pain relief was faster and more profoundly in the VATS group than in the conventional group ( F=3 517.808, P<0.01). Logistic regression analysis indicated that VATS was an independent protective factor for reducing postoperative complications ( OR=0.225, 95% CI:0.121-0.416, P<0.01). Conclusions:During internal fixation of multiple rib fractures, VATS is an effective approach to reduce postoperative pain and complications. Moreover, video-assisted technique is associated with a rapid recovery for patients, resulting in shorter length of hospital stay and less medical costs.
