针型胸腔镜在胸腔肿瘤外科治疗中的临床应用

Clinical application of needle thoracoscopy in thoracic tumor.

目的探讨针型胸腔镜在胸腔肿瘤外科治疗中的应用。方法总结27例胸腔肿瘤患者借助针型胸腔镜探查并根据直视或活检情况决定手术方式的经验。结果所有病例采用针型胸腔镜操作完成探查。术中根据探查情况,放弃手术5例,针型胸腔镜完成手术8例,加辅助小切口9例,中转开胸5例。其中单纯针型胸腔镜下肿块切除2例,病灶局部射频治疗2例,胸膜纤维板剥脱4例。单纯针型胸腔镜操作患者术后并发症少,无大量出血(<300ml)、持续漏气及肺部感染等,住院时间平均9.8d。结论针型胸腔镜探查结合手术为胸腔肿瘤的外科治疗开辟了新的途径。

Objective To investigate the clinical application of needle thoracoscopy in thoracic tumor.Methods Needle thoracoscopic surgeries were performed in 27 thoracic tumor patients from June 2002 to April 2004.All cases underwent probation or biopsy,and if necessary,an appropriate treatment was given.Results The probation was successfully performed by needle thoracoscopy in all cases.According to the results,5 cases were abandoned,8 cases were accomplished with operation under the scopy.9 cases had to extend the assisted mini-incision and other 5 cases were conversed to open thoracotomy.The operative procedures which performed under the scopy were tumor resection in 2 patients,radiofrequency ablation in 3 patients,pleural fibroid tissue decollement in 3 patients.In patients who received only needle scopy surgery,the postoperative complications were fewer,the blood loss was less than 300 ml and no prolonged air leak and pulmonary infections were found.The mean duration of hospitalization was 9.8 d.Conclusion Combine probation with properly operation under needle thoracoscopy offers a new operative method for the treatment of thoracic tumor.