微创肌肉非损伤切口在肺癌手术中的临床价值

Necessity of Non-Damage Muscle Incision as the Conventional Incision for Lung Cancer Surgery

【目的】探讨微创肌肉非损伤切口在肺癌手术中的临床应用价值。【方法】回顾分析本院2007年7月至2014年7月收治的380例肺癌患者的临床资料。采用双腔气管插管静脉复合麻醉，应用微创肌肉非损伤性切口（长约11 cm ）开胸术对其进行手术治疗。【结果】右肺上叶切除180例，右肺中叶切除48例；右肺中下叶切除37例，右肺下叶切除58例，左肺上叶切除32例，左肺下叶切除9例，左全肺切除16例。术中无中转为标准后外侧切口的患者，术中及术后均未见严重并发症。【结论】微创肌肉非损伤切口能满足大多数肺癌手术的需要，能够提供充分的手术视野，操作简便，不影响手术的彻底性。

Objective] To observe the clinical application value of minimally invasive muscle damage inci‐sion in lung cancer surgery ,and to discuss the necessity of lung cancer surgery as a conventional incision .[Methods] Retrospective analysis of 380 patients in our hospital with lung cancer surgery from July of 2007 to July of 2014 of muscle non‐invasive thoracotomy .Applied double lumen endotracheal intubation ,enlarged vi‐sion of incision by two mutually perpendicular retractors and head lamp without blind area .With a long‐handle electrotome ,an electrocautery unit was kept far away from the incision bleeding blood .Both the lung and me‐diastinal lymph node were cleaned .[Results]There were 180 cases of resections of the right upper lobe ,48 ca‐ses of the right middle lobe ,37 cases of the right lower‐middle lobe ,58 cases of the right lower lobe ,32 cases of the left upper lobe ,9 cases of the left lower lobe ,and16 cases of left pneumonectomy .Small chest wall inci‐sion ,little muscle abscission ,and simplified the process of open and closed chest .The procedure had a clear operation field ,good feeling in the chest ,less intraoperative blood loss ,fewer postoperative complications , faster recovery ,shortened length of stay ,reduction of medical expenses ,only a small surgical scar after heal‐ing in chest wall ,good cosmetic effect ,and many other advantages .[Conclusion] The incision can meet the needs of various types of lung cancer surgery with no serious complications .It can provide adequate surgical exposure ,ease of operation ,and does not affect the completeness of surgery .The incision is necessary to the normal operation for the vast majority of lung cancer surgery .