剑突下单孔胸腔镜手术26例报道

Subxyphoid Single-port Video-assisted Thoracic Surgery: Report of 26 Cases

目的 探讨剑突下单孔胸腔镜手术的可行性。方法2014年4月～2015年5月，经剑突下2～2．5cm单孔行胸腔镜手术26例，其中单侧胸腔手术23例，双侧胸腔手术3例。肺大疱切除术17例，肺结节楔形切除术9例。结果手术均顺利完成，无中转开胸，未增加穿刺孔，无术中或术后大出血等并发症。经剑突下单孔行单侧胸腔手术23例，手术时间（42±16）min。术后胸管留置时间（3．0±1．5）d，术后住院时间（5．1±2．2）d。双侧胸腔手术3例，手术时间分别为65、55、42min，术后胸管留置时间4、3、3．5d，术后住院时间5、4、5d。术后随访1～13个月，平均8个月，无切口感染、出血、积液、复发等并发症。结论经剑突下单孔胸腔镜手术治疗简单胸部疾病安全、微创、可行。

Objective To explore the feasibility of subxyphoid single-port video-assisted thoracic surgery for simple thoracic disease. Methods Clinical data of 26 cases of thoracic disease treated by subxyphoid single-port video-assisted thoracic surgery from April 2014 to May 2015 were retrospectively analyzed. The operation was conducted via a single port 2 - 2.5 em below the xiphoid. There were 23 cases of unilateral thoracic surgery and 3 cases of bilateral thoracic surgery. There were 17 cases of bullectomy and 9 cases of wedge resection of pulmonary nodules. Results All the operations were successful without conversion to open surgery. No additional puncture hole was required. No postoperative massive hemorrhage or other complications occurred. In the group of unilateral thoracic surgery, the operative time was （42 ± 16） min, postoperative chest tube indwelling time was （3. 0± 1. 5） d, and postoperative hospital stay was （5.1 ± 2.2） d. In the group of bilateral thoracic surgery, the operative time was 65, 55, 42 min, postoperative chest tube indwelling time was 4, 3, 3.5 d, and postoperative hospital stay was 5, 4, 5 d, respectively. All the patients were followed up for 1- 13 months （mean, 8 months）. No incision infection, hemorrhage, dropsy, pneumothorax, tumor recurrence or other complications were found. Conclusion Subxyphoid single-port video-assisted thoracic surgery for the treatment of simple thoracic disease is a safe, feasible and minimally invasive procedure.