两孔法电视胸腔镜手术治疗肺部疾病:附105例报告

Single-port video-assisted thoracoscopic surgery for pulmonary diseases: analysis of 158 cases

目的探讨两孔法全胸腔镜手术在肺部疾病治疗中应用的可行性及临床价值。方法 2009年10月~2013年12月,采用两孔法全胸腔镜行肺部疾病手术治疗105例患者,其中肺叶切除术19例,肺楔形切除术34例,气胸52例行肺大疱切除术及胸膜粘连术。结果全组患者两孔法手术101例,1例中转开胸手术,3例改为三孔手术;手术时间20~200（50.6±36.8）min,术中出血量10~300（70±56.9）ml。术后胸腔引流管放置时间2~14（4.2±3.2）d,术后住院时间3~16（5.4±3.8）d。术后肺持续漏气6例,肺不张2例,肺部感染2例,余患者术后恢复顺利。结论两孔法全胸腔镜行胸部疾病的诊断和治疗在技术上是安全、可行的,具有创伤小、恢复快等优点。

Objective To assess the clinical value of single-port video-assisted thoracoscopic surgery （VATS） for treatment of pulmonary diseases. Methods From October, 2009 to December, 2013, 105 patients with pulmonary diseases were scheduled for single-pore VATS for pulmonary lobectomy （19 patients）, wedge resection of the lung （34 patients）, and bullae resection and pleurodesis for spontaneous pneumothorax or pulmonary bleb （52 patients）. Results Of the 105 patients, 101 patients underwent single-port VATS; the procedure was converted to open thoracotomy in 1 patient and to conventional three-port VATS in 2 patients. The operative time was 50.6±36.8 min （20-200 min） with intraoperative blood loss of 70±56.9 ml （10-300 ml）, thoracic drainage time of 4.2±3.2 days （2-14 days）, and postoperative hospital stay of 5.4±3.8 days （3-16 days）. Postoperative complications of the procedures induded prolonged air leakage （6 cases） and atelectasis （2 cases）. All the other patients recovered smoothly without serious complications. Conclusion Single-port VATS is a safe and efficient procedure that allows rapid postoperative recovery and is a method of choice for selected patients with pulmonary diseases.