微创电视胸腔镜技术临床应用

Clinical application of micro-invasive by video assisted thoracoscopy surgery

目的总结分析56例电视胸腔镜手术(VATS)。方法手术疾病包括动脉导管未闭、自发性气胸、纵隔肿瘤和肺部良、恶性疾病等。动脉导管未闭、自发性气胸、局限性肺大疱切除采用纯腔镜操作,切口为3个孔;肺叶切除、纵隔肿瘤采用辅助4～8cm左右小切口;2008年以后肺大疱切除时采用单孔操作。结果56例VATS手术均成功。手术时间30～110min,平均60min。术中出血50～100ml。术后病人切口微痛,双上肢活动自如。胸腔闭式引流管放置48～72h,引流液50～350ml。住院时间7～27天,平均14天。结论VATS治疗某些胸部疾病是可行的,有较好的治疗效果,值得进一步推广。

Objective To summarize and analyze 56 cases by video assisted thoracoscopy surgery （VATS）. Methods The data included patent ductus arteriosus （ PDA）, spontaneous pneumothorax, mediastinal mass and nonmalignant or malignant lung disease. Operation of PDA, spontaneous pneumothorax and circumscribed bunamiodyl were applied to simplex thoracoscope, and incision was three holes. Operation of pulmonary lobectomy and mediastinal mass assisted were applied to small incision of 4 to 8cm, but bunamiodyl ectomy were applied by single foramen since 2008. Results All of operations were successful. Operative time was between 30 and 100 minutes, and the mean value was 60 minutes. Length of stay was between 7 and 27 days, and the mean value was 14 days. Conclusion VATS is feasible to some of the thoracopathy. It has better therapeutic efficacy and is worth further applying and generalization.