Comparative study of fluorescence staining method and inflation-deflation method for thoracoscopic pulmonary tuberculosis segmentectomy

doi:10.19982/j.issn.1000-6621.20240433

Abstract

Abstract:

Objective: To compare and analyze the clinical efficacy of fluorescence staining method and inflation-deflation method in thoracoscopic pulmonary tuberculosis (PTB) segmentectomy. Methods: Clinical data of 96 PTB patients who underwent thoracoscopic pulmonary segmentectomy at Department of Thoracic Surgery, Public Health Clinical Center of Chengdu from January 2021 to May 2024 were retrospectively collected. The patients were divided into a fluorescence staining group (63 cases) and an inflation-deflation group (33 cases) according to the method in determining the intersegment. We compared and analyzed the differences in the time to determine the intersegmental plane, surgical duration, intraoperative blood loss, postoperative drainage time, postoperative hospital stay duration, and incidence of postoperative complications between the two groups. Results: The time to determine the intersegmental plane in the fluorescence staining group ((28.98±9.32) s) was significantly shorter than that in the inflation-deflation group ((1077.56±194.00) s), with statistically significance (t=-42.656,P<0.001). However, there was no statistically significant difference in surgical duration ((141.32±67.50) min), intraoperative blood loss (100 (50, 200) ml), postoperative drainage time ((7.08±4.24) d), postoperative hospital stay ((10.73±4.32) d), postoperative complication rate (23.81% (15/63)) in the fluorescence staining group compared to the inflation-deflation group ((129.24±61.70) min, 100 (50, 100) ml, (7.21±3.06) d, (9.55±4.15) d, 12.12% (4/33), respectively)(t=-0.857, P=0.394; Z=-0.973, P=0.334; t=0.159, P=0.874; t=1.293, P=0.199; χ²=1.864, P=0.172). Conclusion: The fluorescence staining thoracoscopy technology is safe and effective in determine the intersegment plane during thoracoscopic segmentectomy for PTB without increasing intraoperative blood loss, surgical time, postoperative drainage time, hospital stay time, or complications. This technology is worthy of clinical reference and promotion.

Key words: Tuberculosis, pulmonary, Pneumonectomy, Thoracoscopes, Photofluorography, Collapse therapy

CLC Number:

R521
R605

Gong Sheng, Wang Ning, Li Dan, Li Gang, Liu Yu, Jiang Liangshuang, Yao Xiaojun. Comparative study of fluorescence staining method and inflation-deflation method for thoracoscopic pulmonary tuberculosis segmentectomy[J]. Chinese Journal of Antituberculosis, 2025, 47(3): 292-297. doi: 10.19982/j.issn.1000-6621.20240433

Figures/Tables 4

References 22

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临床特征	荧光染色组(63例)	膨胀萎陷组(33例)	统计检验值	P值
年龄(岁,$\bar{x}±s$)	36.98±11.05	36.39±11.96	t=-0.203	0.840
性别[例,构成比(%)]			χ²=1.441	0.230
男性	36(57.14)	23(69.70)
女性	27(42.86)	10(30.30)
体质量指数($\bar{x}±s$)	21.63±2.97	21.56±3.12	t=-0.106	0.916
抗结核治疗时间[d,M(Q₁,Q₃)]	40.50(18.00,70.25)	46.50(32.00,63.50)	Z=1.334	0.184
淋巴细胞计数(10⁹/L,$\bar{x}±s$)	1.22±0.38	1.30±0.33	t=-1.059	0.292
血红蛋白(g/L,$\bar{x}±s$)	129.79±24.16	132.51±30.67	t=-0.478	0.634
结核病类型[例,构成比(%)]			χ²=4.175	0.131
结核瘤	19(30.16)	5(15.15)
空洞性肺结核	38(60.32)	21(63.64)
纤维干酪样肺结核	6(9.52)	7(21.21)
病变部位[例,构成比(%)]			χ²=1.077	0.299
上叶	50(79.37)	29(87.88)
下叶	13(20.63)	4(12.12)
手术方式[例,构成比(%)]			χ²=0.351	0.917
单孔	6(9.52)	4(12.12)
单操作孔	5(7.94)	2(6.06)
三孔	52(82.54)	27(81.82)
切除肺段[例,构成比(%)]			χ²=6.722	0.473
尖段	14(22.22)	10(30.30)
后段	6(9.52)	6(18.18)
尖后段	17(26.98)	6(18.18)
前段	2(3.17)	1(3.03)
固有段	9(14.29)	4(12.12)
舌段	1(1.59)	2(6.06)
背段	9(14.29)	4(12.12)
基底段	5(7.94)	0(0.00)

指标	荧光染色组(63例)	膨胀萎陷组(33例)	统计检验值	P值
判定肺段段间平面的时间(s,$\bar{x}±s$)	28.98±9.32	1077.56±194.00	t=-42.656	<0.001
手术时间(min,$\bar{x}±s$)	141.32±67.50	129.24±61.70	t=-0.857	0.394
术中失血量[ml,M(Q₁,Q₃)]	100(50,200)	100(50,100)	Z=-0.973	0.334
引流时间(d,$\bar{x}±s$)	7.08±4.24	7.21±3.06	t=0.159	0.874
术后住院时间(d,$\bar{x}±s$)	10.73±4.32	9.55±4.15	t=-1.293	0.199
并发症[例,发生率(%)]
术后肺部感染	15(23.81)	4(12.12)	χ²=1.864	0.172
持续性肺漏气	21(33.33)	11(33.33)	χ²=0.023	0.880
其他	10(15.87)	2(6.06)	χ²=1.906	0.209