胸腔镜辅助小切口肺叶及全肺切除的临床应用体会

Clinical application of anatomical Lobectomy and pneumonectomy by video-assisted thoracoscopic Surgery

目的:探讨胸腔镜辅助小切口肺叶及全肺切除术在肺部良性疾病和非小细胞肺癌治疗中的可行性。方法:41例在全麻下应用胸腔镜进行肺部手术,其中肺叶切除38例,全肺切除3例;良性疾病10例,肺癌31例。其中部分病例(16例)辅助6～8 cm的小切口,在电视监视及辅助小切口直视下进行解剖肺叶或全肺切除。结果:全组无严重并发症。手术时间1.5～4 h,平均2.5 h。术中出血量100～500 mL,平均200 mL。随访6～46个月,平均17个月,其中31例肺癌随访8～46个月,3例分别于术后8个月,12个月及16个月出现肝脏、双肺转移死亡。结论:胸腔镜辅助小切口行肺叶及全肺切除术是可行的。

Objective：To evaluate the feasibility of video-assisted minimal access surgery for lobectomy and pneumonectomy in the benign pulmonary diseases and non-small cell lung cancer treatment.Methods：Under general anesthesia,via a video-assisted minimal access approach,anatomical lobectomy or pneumonectomy was partially performed through a 6 to 8 cm incision.A total of 41 patients,including 31 pati-ents with lung cancer and 10 with benign tumor,received lobectomy（38 cases） or pneumonectomy（3 cases）,which were performed under a video vision and a direct vision through the small incision.Results：The group without serious complications due to operation.The average operation time was 2.5 h（1.5-4h）,and average blood loss was 200m l（100-500ml）.41 cases were followed up for 6 - 46 months,average 17 months.Among the 31 patients with lung cancer,who were followed up for 8-46 months,3 died of liver and bilateral lungs metastasis 8,12,or 16 months after the operation.Conclusion： Video-assisted minimal access surgery is feasible for lobectomy and pneumonectomy.