电视胸腔镜手术113例报告

Clinical application of video-assisted thoracic surgery:with a report of 113 cases

目的:探讨电视胸腔镜手术(video-assisted thoracic surgery,VATS)的临床价值及疗效。方法:回顾分析2002年4月至2011年6月为113例患者行VATS的临床资料,其中自发性气胸21例,胸外伤38例,肺良性疾病11例,周围性肺癌35例,胸膜疾病4例,纵隔肿瘤4例。结果:113例均顺利完成手术。术后3例并发急性呼吸功能衰竭,经呼吸机辅助机械通气治疗后好转;1例发生急性心肌梗死,治疗后痊愈;余均无并发症发生。2～5 d拔除胸腔闭式引流管,平均3.4 d。患者均痊愈出院。结论:(1)胸腔镜手术具有患者创伤小、手术时间短、术后疼痛轻、康复快、美观等优点;(2)诊断性电视胸腔镜技术可在微小创伤下全面探查胸腔,周围型肺结节、胸膜、纵隔、胸外伤等疾病可得到早期准确诊断;(3)自发性气胸、肺大泡是胸腔镜手术的最佳适应证;(4)胸腔镜手术是早期周围型肺原发肿瘤及肺部良性病变的重要术式选择之一。

Objective：To evaluate the diagnostic and therapeutic value of video-assisted thoracic surgery（VATS） in general thoracic surgery.Methods：The clinical data of 113 cases of video-assisted thoracic surgery from Apr.2002 to Jun.2011 were retrospectively analyzed.The indications included spontaneous pneumothorax of 21 cases,chest trauma of 38 cases,benign lung lesions of 11 cases,peripheral lung cancers of 35 cases,pleural lesions of 4 cases,and mediastinal tumors of 4 cases.Results：All procedures were successful.No severe intra-operative complications occurred.Post-operative complications included 3 cases of acute respiratory failure,1 case of acute myocardial infarction,and all recovered after several days of treatment.No mortality occurred.The average drainage time was 3.4 days（2-5 days）.Conclusions：Video-assisted thoracic surgery has its character of less invasion,shorter operation time,and lighter pain;diagnostic thoracoscopic surgery makes it easy to explore intra-thoracic organs and makes early diagnosis feasiblely;spontaneous pneumothorax and pulmonary bulla are the main indication of video-assisted thoracic surgery;video-assisted thoracic surgery is a optional method for early peripheral lung cancer,as well as an important therapeutic method for benign pulmonary lesions.