完全胸腔镜肺叶切除术诊治肺良性疾病50例分析

Application of video-assisted thoracoscopic lobectomy in the diagnosis and treatment of 50 patients with benign pulmonary disease

目的探讨完全电视胸腔镜(VATS)肺叶切除术在肺良性疾病诊断治疗中的应用价值。方法我科行肺良性疾病胸腔镜肺叶切除术50例。其中辅助小切口2例,全胸腔镜肺叶切除48例,术中送冰冻切片病理检查。结果全组无围手术期死亡,围手术期并发症3例(6%)。手术平均时间109 min;术中平均出血量89 ml;术后胸液平均268 ml;术后平均置管时间4.9天;术后平均住院时间6.7天。术后病理:炎性假瘤11例,肺结核球13例,肺囊肿7例,错构瘤2例,支气管扩张5例,硬化性血管瘤3例,曲霉菌病2例,肺隔离症3例,肺脓肿2例,腺瘤2例。结论胸腔镜肺叶切除手术可同时达到诊断和治疗肺良性疾病的目的,且具有创伤小,恢复快,切口美观等优点。

Objective To explore the application value of video-assisted thoracoscopic lobectomy in the diagnosis and treatment of patients with benign pulmonary disease. Methods 50 patients with benign pulmonary diseases were treated by video-assisted thoraco- scopic lobectomy. 48 cases were accomplished by video-assisted thoracoscopic surgery, and 2 cases were accomplished by video-assisted mini incision. The microtome sections were frozen to analyze its pathology. Results There was no death reported and complications oc- curred in 3 cases （6%） during perioperative period. The average operation time was 109 min ; the average blood loss was 89 ml ; the aver- age peri-operative bleeding was 268 ml ; the average duration of drainage was 4.9 days ; the average postoperative duration of hospital stay was 6.7 days. The pathologic results were ： 11 cases of inflammatory pseudotumor, 13 cases of tuberculoma, 7 cases of pulmonary cyst, 2 cases of hamartoma, 5 cases of bronchiectasis, 3 cases of sclerosing hemangioma, 2 cases of pulmonary aspergillosis, 3 cases of pulmonary sequestration, 2 cases of pulmonary abscess, and 2 cases of pulmonary adenoma. Conclusion Video-assisted thoracoscopic lobectomy can simultaneously achieve the purpose of diagnosis and treatment of patients with benign pulmonary diseases. Besides, it has the advanta- ges of mini-invasive, quick recovery, and beautiful incision.