电视胸腔镜手术在胸腔积液诊治中的应用

Single utility port complete VATS biopsy and treatment for pleural effusion

目的探讨单操作孔电视胸腔镜手术（video-assisted thoracoscopic surgery,VATS）在诊治胸腔积液中的可行性、有效性和临床价值。方法 2008年2月至2010年10月共施行单操作孔电视胸腔镜手术治疗胸腔积液26例,术中吸净胸腔积液探查胸膜腔,活检钳于胸膜病灶处多处取活检,恶性胸腔积液予胸膜腔喷洒滑石粉行胸膜固定。结果 26例术后确诊：转移性腺癌10例,腺癌8例,结核6例,炎症2例。施行胸膜固定术18例。手术时间35~60 min,平均45 min。无严重并发症及围手术期死亡。结论单操作孔电视胸腔镜手术诊治胸腔积液是一种安全有效微创的术式,具有创伤更小、恢复更快等优势。

Objective The aim of this study was to explore the feasibility and clinical value of treatment for pleural effusion with single utility port complete VATS.Methods From February 2008 and October 2010,26 cases underwent of treatment for pleural effusion with single utility port complete VATS.The pleural fluid was drawn out and exploration with biopsy was conducted under single utility port complete VATS.For 18 patients with malignant hydrothorax.talcum powder was applied for pleurodesis.Results A confirmative diagnosis was obtained by single utility port complete VATS in all the 26 patients,including metastatic adenocarcinoma in 10 patients,adenocarcinoma in 8 patients,tuberculosis in 6,and inflammation in 2.For 18 patients with malignant hydrothorax.talcum powder was applied for pleurodesis.The operation time was 35~60 min（mean,45 min）.A11 the operations were successful and the patients recovered smoothly without severe postoperative complications.Conclusion Single utility port complete VATS is one of effective methods for biopsy and treatment of pleural effusion.It has the advantages of minimal invasive and rapid recovery.