胸腔镜辅助小切口肺癌根治术102例

Video-assisted mini-thoracotomy pulmonary lobectomy on 102 lung cancer patients

背景与目的:随着胸腔镜(V ideo-assisted thoracoscop ic surgery,VATS)技术的迅速发展,现在大多数肺癌的外科治疗可以安全地在胸腔镜下手术完成,一些胸外科医生很关注胸腔镜手术的安全性和彻底性。胸腔镜辅助小切口(V ideo-assisted m in i-thoracotomy,VAMT)扩展了手术的适应范围,使解剖上彻底的肺叶切除术及淋巴结清扫更容易。本文旨在探讨和总结胸腔镜辅助小切口肺叶切除术的临床价值。方法:总结102例胸腔镜辅助小切口下肺叶切除的手术方法及临床效果。结果:全组无手术死亡及严重并发症。平均手术时间与术后胸腔引流管时间分别为126分钟和3.5天,术中出血平均165m。l术后疼痛轻、恢复快,3年生存率87.8%和传统开胸手术组无差异。结论:胸腔镜辅助小切口肺叶切除及淋巴结清扫安全、彻底,效果确切。只要严格掌握手术适应证,运用合理的手术方法和技巧,一般可以达到与常规开胸同样的治疗效果,扩展了胸腔镜手术的适应范围。

Background and purpose： With the development of Video-assisted thoracoscopic surgery technology, most pulmonary lobectomies couht be safely performed under VATS. Because some thoracic surgeons were concerned regarding the safety anti radical cure of VATS. Video-assisted mini-thoracotomy（VAMT） made it easy to complete an anatomic reseetion and node dissections. The purpose of this paper is to explore the applied values of VAMT pulmonary lobectomy. Methods： The elinieal results of 102 cases operated by Video-assisted mini-thoracotomy pulmonary lobectomy were analyzed retrospectively. Results： There were no mortalities or serious complication associated with the operation. The mean time of operation and chest drainage was 126 minutes and 3.5 days, respectively. The mean blood loss during operation was 165ml. The pain after operation was mild and postoperative recovery was shortened, compared to traditional thoracotomy . 3-year survival rate was 87.8%. Conclusions： Video-assisted mini-thoracotomy pulmonary lobectomy is a safe and effective procedure in thoracic surgery with minimal invasion. It could achieve the same therapeutic results as conventional open surgery and expand the indication of video-assisted thoracoscopy.