摘要
目的 总结单操作孔全胸腔镜肺叶切除术(VATS)的初步经验。方法 2009年12月至2015年5月间江苏省肿瘤医院共进行单操作孔全胸腔镜下肺叶(肺段)切除术71例[其中男性33例,女性38例;年龄38~72岁,平均(55.5±6.9)岁],其中1例左上肺叶袖状切除术,2例肺段切除术。结果 单操作胸腔镜肺叶切除术手术时间108~320 min,平均(162.9±56.8)min;操作孔长度2.5~6.0 cm,平均(3.2±0.8)cm;每例患者淋巴结清扫枚数目8~21枚,平均(13.4±4.6)枚;其中2例术中出血,中转开胸,其余均手术顺利。胸腔闭式引流时间术后3~19 d,平均(3.8±3.1)d;住院时间7~35 d,平均(9.8±5.6)d;无围手术期死亡及重大并发症发生。结论 单操作孔VATS肺叶切除术安全、可靠,是创伤更小的胸腔镜下手术方式,具有很好的临床推广前景。
Objectives This study summed up an initial experience of a single utility video-assisted thoracoscopic surgery (VATS) lobectomy. Methods A total of 71[ male 33, female 38; mean age (55.5 ± 6.9 )years old, range 38-721, who underwent major pulmonary resection (segmentectomy, lobectomy, sleeve lobectomy) through a consecutive VATS using a single utility from Dec. 2009 to May 2015, were included in this study. Lobectomy was performed in most patients ( n = 38 ), and sleeve lobectomy was performed in 1 patient, and segmentectomy in 2 patients. Results The mean time of the operation, in 71 patients who were completed by two-incisions VATS lobectomy, was [ ( 162. 9 ± 56.8) minutes ( range, 108-320) minutes ]. The utility incision length was [ ( 3.2 ± 0.8 ) cm ( range, 2.5-6.0)cm]. The total number of dissected lymph nodes per patient was [ (13. 4 ± 4. 6)range, 8-21 range]. Conversion to thoracotomy was performed in 2 patients (2.8%) due to bleeding at pulmonary arterial branch. The chest tube was removed on postoperative day [ (3.8 ± 3.1 )range, 3-19 range], and the mean time of hospitalization was [ (9.8 ± 5.6) days, range 7-35 days ]. There was no occurrence of major perioperative morbidity and mortality. Conclusion In the hands of experienced VATS surgeons,it is safe and feasible to perform VATS lobectomy with a single utility.
出处
《中华腔镜外科杂志(电子版)》
2016年第4期228-231,共4页
Chinese Journal of Laparoscopic Surgery(Electronic Edition)
基金
江苏省六大高峰人才重大课题(N2012-ws-115)
江苏省肿瘤医院院课题(ZM201304)
关键词
单操作孔
胸腔镜
肺叶切除术
Single
Video- assisted thoracoscopic surgery (VATS)
Lobectomy