电视胸腔镜手术治疗转移性肺肿瘤

Video-assisted thoracoscopic surgery for metastatic lung tumors

目的探讨肺转移瘤电视胸腔镜手术(video-assistedthoracoscopicsurgery,VATS)的治疗效果。方法回顾分析31例VATS治疗肺转移瘤的临床资料,其中肺叶切除2例,肺叶切除联合转移瘤摘除1例,肺叶切除联合胸壁转移瘤切除1例,肺段切除2例,肺楔形切除20例,肺楔形切除联合转移瘤摘除5例。结果无住院死亡,术后呼吸功能不全1例,肺部感染2例、持续肺疱漏气2例、胸腔积液3例,经抗生素治疗、持续胸腔闭引流后治愈。1例肝癌肺转移术后2个月发现腰椎骨转移,转骨科行手术治疗。1年生存率71·0%(22/31),3年生存率38·7%(12/31)。结论VATS治疗有手术指征的肺转移瘤可行、安全。

Objective To evaluate the effectiveness of video - assisted thoracoscopic surgery （VATS） for metastatic lung tumors. Methods Clinical records of 31 cases of metastatic lung tumors treated by VATS were retrospectively analyzed. There were 2 cases of lohectomy, 1 case of lohectomy and metastasectomy, 1 case of lohectomy and resection of metastatic tumor in the chest wall,2 cases of segmentectomy, 20 cases of wedge resection, and 5 cases of wedge resection and metastasectomy. Results No fatal cases were observed. Postoperative complications, including 1 case of respiratory insufficiency, 2 cases of pulmonary infection, 2 cases of continuous alveolar leakage and 3 cases of pleural effusion, were cured by antibiotic therapy and closed thoracic drainage. One case of lung metastasis from primary liver cancer was found lumbar vertebral metastasis at 2 months after operation and was referred to the Department of Orthopedics for further treatment. The 1 - and 3 - year survival rates were 71.0% （22/31） and 38.7% （ 12/31 ） ,respectively. Conclusions Video - assisted thoracoscopic surgery is a feasible and safe treatment for metastatic lung tumors with surgical indications.