电视辅助胸腔镜在胸部肿瘤外科的应用

Application of video-assisted thoracoscopic surgery in thoracic tumors

背景与目的随着内镜器械及手术技术的改善,电视胸腔镜在临床的应用愈来愈广泛。本研究的目的是总结并讨论电视辅助胸腔镜外科(videoassistedthoracoscopicsurgery,VATS)技术在76例胸部肿瘤患者治疗中的应用。方法回顾分析1997年7月至2004年6月应用VATS技术治疗76例患者的临床资料,手术包括肺楔形切除术、食管平滑肌瘤摘除术、支气管囊肿摘除术、纵隔囊肿摘除术等。结果全组患者接受VATS治疗,其中8例肺癌患者中转开胸行肺叶切除术。全组患者无死亡,并发症少,全部痊愈出院。结论VATS具有创伤小、痛苦轻、恢复快和术后并发症少等优点,在胸部良性肿瘤的治疗中具有很大的优势,但在胸部恶性肿瘤的治疗上应严格掌握其适应证。

Background and objective With the improvement of instrument and operative technique, video-assisted thoracoscopy is more and more widely used. The aim of this study is to summarize and discuss the results of video-assisted thoracoscopic surgery （VATS） in 76 patients with thoracic tumors. Methods The data of 76 cases were analyzed retrospectively. From July 1997 to June 2004, 76 patients （46 men and 30 women） with thoracic tumors underwent VATS for peripheral pulmonary nodules （52）, leiomyoma of esophagus （10）, mediastinal lymphadenectasis （6）, malignant pleural fluid （5）, bronchogenic cyst （1）, mediastinal cyst （1）, neurofibroma （1）. Results All procedures were performed successfully under VATS except for 8 cases, who were converted to thoracotomy for lung cancer. There was no mortality or severe complication in this series. Conclusion VATS is a safe and effective technique in selected patients with thoracic lesions. The overall incidence of perioperative complication is low. VATS has obvious advantages in treatment of benign thoracic lesions, however, the indications should be selected carefully for malignant tumors.