全胸腔镜肺叶切除治疗早期肺癌手术体会

Operative experience of completely thoracoscopic lobectomy on early stage of lung cancer

目的总结全胸腔镜肺叶切除治疗早期肺癌的手术体会。方法 6例早期肺癌患者手术采用双腔气管插管全身麻醉,健侧单肺通气。所有操作过程均在胸腔镜下完成,不放置开胸器,不牵开肋骨,基本操作顺序与传统开胸肺叶切除相同,均清扫纵隔淋巴结。结果 6例患者手术均顺利,无围术期死亡患者,无严重并发症发生。结论全胸腔镜肺叶切除治疗早期肺癌手术操作难度较大,风险较高,开展此项手术需要有清晰的胸腔镜设备,熟练地掌握纵隔淋巴结清扫技术,并且需要较多病例操作经验积累和较长的学习曲线。

Objective To summarize the operative experience of completely video-assisted thoracoscopic lobectomy on early stage of lung cancer.Methods All procedures were conducted under general anesthesia with double lumen.All of operational process were completed under thoracoscope without rib-spreading.Anatomic lobectomy was performed with systemic mediastinal lymph node dissection.Results All procedure were carried out smoothly with no case of serious complications and death.Conclusion Completely video-assisted thoracoscopic lobectomy for early stage of lung cancer is more difficult and risker than thoracotomy.Meanwhile,it needs clear thoracoscope,favorable operative field show,corrective operational process,skillful vascular separation technique,the ability of imbedding bronchus and vessel in suture retractor and handling systemic mediastinal lymph node dissection.