全电视胸腔镜下肺叶切除术的临床疗效观察

Observation on the clinical therapeutic effect of completely video-assisted thoracoscopic lobectomy

目的 探讨全电视胸腔镜肺叶切除的手术方法及可行性.方法 选择行全电视胸腔镜下肺叶切除患者 39 例,其中男 25 例,女14例,所有病例均采用3孔法进行肺叶切除,术中应用切割闭合器处理血管及支气管.术后观察所有病例的病理分型、并发症、胸管引流量、胸管放置时间以及住院时间等.结果 病理诊断支气管扩张症2例,肺错构瘤3例,肺硬化性血管瘤3例,肺癌31例.术后出现皮下气肿5例,脓胸1例,肺不张3例,切口感染2例,心律失常3例.术后平均胸管引流量50～200 ml/d,平均住院时间9.5 d.全组无死亡病例.结论 全电视胸腔镜肺叶切除术治疗肺部疾病在技术上是可行的,胸外科医师经过相关培训完全能掌握这项微创技术.

Objective To evaluate the methods and the feasibility of completely video-assisted thoracoscopic（ VATS ） lobectomy. Methods VATS lobectomy was performed in 39 patients, including 25 men and 14 women. All cases were performed through three-hole method, and the endoscopic stapler was applied for the hilar vessel and bronchus dissection and occlusion. The pathology, complications, post-draining volume, postoperative chest tube time, and the length of hospital stay in after operation were analyzed. Results Pathologic diagnoses were as follows： 2 bronchiectasis, 3 pulmonary hamartomas, 3 Sclerosing hemangioma, and 31 lung cancers. The drainage volume of the chest tube was about 50 - 200ml/d, and the length of hospital stay was 9.5 days. There was no mortality. Conclusions Complete VATS lobectomy is technically safe and feasible for patients with lung diseases. Special trained thoracic surgeons could become master of this new minimal invasive surgical technology.