【摘要】 目的 探讨三维重建术辅助三孔电视胸腔镜在胸腺瘤扩大切除术中的应用。方法 选取2021年3月至6月上饶市人民医院心胸外科行胸腺瘤扩大切除术的60例胸腺瘤患者为研究对象，采用随机数字表法分为观察组及对照组，各30例。两组患者均接受三孔电视胸腔镜下胸腺瘤扩大切除术，两组患者均根据CT增强图像进行术前规划及术中应用，观察组在此基础上利用三维重建技术根据CT数据建立三维图像，并以此进行术前规划及术中应用。比较两组患者的围手术期指标、术后并发症发生情况及随访结果。结果 观察组的手术时间、引流管留置时间、住院时间均短于对照组，术中出血量、引流量均低于对照组，差异有统计学意义（P<0.05）。观察组在院期间并发症总发生率低于对照组，差异有统计学意义（P<0.05）。术后6个月，获得随访患者中对照组患者出现前纵隔脂肪软组织残留1例，两组患者的欧洲癌症研究和治疗组织的生活质量问卷（EORTC-QLQ）评分比较，差异无统计学意义（P>0.05）。结论 三维重建术辅助三孔电视胸腔镜行胸腺瘤扩大切除术可有效提高手术效率、减少手术损伤，促进患者术后恢复。更多还原

【Abstract】 Objective To explore the application of three-port video-assisted thoracoscopy assisted by three-dimensional reconstruction in extended thymectomy. Methods A total of 60 patients with thymoma undergoing extended thymectomy in Department of Cardiothoracic Surgery, ShangRao People′s Hospital from March to June 2021 were selected as the research objects. According to random number table method, they were divided into observation group and control group, with 30 cases in each group. All patients underwent extended thymectomy under three-port video-assisted thoracoscopy. According to contrast-enhanced CT images, patients in both groups were given preoperative planning and intraoperative application. On this basis, three-dimensional reconstruction was applied to construct three-dimensional images in observation group. The preoperative planning and intraoperative application were conducted based on these methods. The perioperative indexes, postoperative complications and follow-up results were compared between the two groups. Results The operation time, indwelling time of drainage tube, hospitalization time in observation group were shorter than those in control group, intraoperative blood loss, drainage volume in observation group were lower than those in control group, the differences were statistically significant(P<0.05). Total incidence of complications was lower than that in control group, the difference was statistically significant(P<0.05). At 6 months after surgery, there was 1 case with residual anterior mediastinal fat and soft tissues in control group. There was no significant difference in the European Organization for Reasearch and Treatment of cancer-quality of life questionnaire(EORTC-QLQ) score between the two groups(P>0.05). Conclusion The application of three-dimensional reconstruction in extended thymectomy under three-port video-assisted thoracoscopy can effectively improve surgical efficiency, reduce surgical injury and promote postoperative recovery of patients.更多还原