电视胸腔镜辅助下治疗肺癌52例体会

Experiences of video-assisted thoracoscopic radical resection for lung cancer in 52 patients

目的探讨电视胸腔镜辅助下根治性肺癌切除的可行性。方法回顾分析2005年4月-2006年8月,电视胸腔镜辅助下治疗肺癌52例的临床资料,其中中心型10例,周围型42例。结果施行肺叶切除40例(其中双腋下小切口行右肺上叶切除,上腔静脉侧壁部分切除加双侧纵隔淋巴结清扫术1例),全肺切除2例,肺叶袖切除4例(其中右肺上叶袖切除2例,左肺上叶袖切除加肺动脉成形2例)。清扫肺门淋巴结520枚(平均6￣15枚),纵隔淋巴结416枚(平均4￣13枚),其中转移淋巴结125枚,阳性率13.4%。手术时间2.0 h￣6.5 h,平均3.5 h。术中出血量80￣400 m l。术后胸腔闭式引流时间2 d￣15 d,平均4.5 d。术后住院8 d￣15 d,平均10.5 d。围术期死亡1例,为右肺上叶袖切除加肺动脉成形,术后并发支气管胸膜瘘。余51例术后随访3个月￣38个月,9例死于肺外转移。结论电视胸腔镜辅助下对于肺癌行根治性手术治疗可行。

Obfective To explore the feasibhty of video-assisted.thoracoscopic radical resection for lung cancer.Methods The clinical data of 52 cases with lung cancer who underwent Video-assisted thorocoscopic radical resection from April 2005 to August 2006 was retrospectively reviewed, 10 cases of them were central cancer, and the other 42 eases were penipheral cancer.Results Pulmonary lobectomy was taken on 40 cases,total lung resection on two cases, and minimal eccess surgery for lobectong on four cases：Lymph nodes were resected, including 520 pulmonary hialar nodes and 416 mediastinal nedes,125 nodes of which were positive,accounting for 13.4% （ 125/936）.The mean operation time was 3.5 h （2.0 h-6.5 h ）, The mean intraoperafion bleeding was 80-400 ml, the mean post-operation chest drainage time4.5 d（2 d-15 d）, and the mean post-operation hospital-stay time was 10.5 d （8 d-15 d）, one case were died in perioperation with pulmonar, lobectomy taken and pulmonary artery angioplasty performed,complicated with bmnchopleural fistula.The other 51 cases were followed up 3-38 months, 9 cases of them were died from metastases of lung cancer.Conclusion video assisted thoracoscopic radical resection for lung cancer was feasible.