单操作孔胸腔镜肺叶切除术治疗肺良性疾病

Single Utility Port Video-assisted Thoracoscopic Lobectomy for Benign Pulmonary Diseases

目的探讨单操作孔胸腔镜下肺叶切除术对治疗肺良性疾病的价值。方法 2011年1月至2014年4月,苏州大学附属第一医院心胸外科对48例肺良性疾病患者施行单操作孔胸腔镜下肺叶切除术,其中男21例、女27例,平均年龄47.4岁,行右肺上叶切除术10例,右肺中叶切除术5例,右肺下叶切除术5例,左肺上叶切除术8例,左肺下叶切除术20例。分析手术时间、术中失血量、术后胸腔引流管放置时间、术后住院时间及术后并发症。结果全组中2例因血管鞘周围淋巴结包绕分离肺动脉分支出血中转开胸;手术时间(147.2±50.4)min,术中失血量(160.2±25.3)ml,术后胸腔引流管放置时间(4.8±2.8)d,术后住院时间(7.4±1.9)d。无围手术期死亡及严重并发症发生,术后肺持续漏气2例,肺部感染2例,均经保守治疗后痊愈。术后病理诊断:支气管扩张症17例,炎性假瘤11例,结核9例,真菌感染4例,肺隔离症3例,肺囊肿2例,肺脓肿1例,错构瘤1例。48例经门诊或电话随访,平均随访6个月,无严重并发症发生。结论单操作孔胸腔镜下肺叶切除术治疗肺良性疾病是安全可行的。

Objective To evaluate the safety and efficacy of single utility port video-assisted thoracoscopic lobec- tomy in the treatment of benign pulmonary diseases. Methods From January 2011 to April 2014, 48 patients with benign pulmonary diseases underwent single utility port video-assisted thoracoscopic lobectomy in the First Affiliated Hospital of Soochow University. The patients included 21 males and 27 females, with their mean age of 47.4 years. There were 5 patients received right upper lobectomy, right middle lobectomy in 5 patients, right lower lobectomy in 5 patients, left upper lobectomy in 8 patients, and left lower lobectomy in 20 patients. The clinical outcomes induded operation time, intraoperative blood loss, chest drainage duration, postoperative hospital stay and postoperative complications. Results There were 2 patients conversion to open surgery. The average operation time was 147.2±50.4 min, intraopera- tire blood loss was 160.2±25.3 ml, postoperative chest drainage duration was 4.8±2.8 d, postoperative hospital stay was 7.4±1.9 d. There was no hospital death or serious postoperative complications. Postoperative pathological diagnosis showed bronchiectasis in 17 patients, inflammatory pseudotumor in 11 patients, tuberculosis in 9 patients, aspergillosis in 4 patients, pulmonary sequestration in 3 patients, bronchogenic cyst in 2 patients, pulmonary abscess in 1 patient, and hamartoma in 1 patient. No long-term complications were noticed in 48 patients during a mean follow-up of 6 months. Conclusion Single utility port video-assisted thoracoscopic lobectomy is safe and feasible in the treatment of benign pulmonary diseases.