单操作孔电视胸腔镜肺叶切除治疗肺癌的临床研究

Clinical study on single port video-assisted thoracoscopic lobectomy for treatment of lung cancer

目的探讨单操作孔电视胸腔镜肺叶切除(SP-VATS)治疗肺癌的临床疗效。方法回顾性分析接受单操作孔电视胸腔镜行肺叶切除的96例患者临床资料,均为恶性病变,其中男56例,女40例,肿瘤位于右肺上叶25例,右肺中叶3例,右肺下叶16例,左肺上叶24例,左肺下叶28例,均行肺叶切除+系统淋巴结清扫术。结果 96例均手术成功,无中转开胸手术者,2例因胸腔黏连较重,增加副操作孔一个,无术中输血,手术时间80~190 min,平均130 min;术中出血量60~300 m L,平均100 m L;住院时间3~14 d,平均6.5 d;术中清扫淋巴结11~32枚,平均17枚。术后持续漏气(大于1周)2例,胸腔积液5例。结论单操作孔电视胸腔镜肺叶切除具有创伤小、恢复快、住院时间短、淋巴结清扫彻底等优点,可作为手术切除肺癌的首选治疗方法。

Objective To investigate the clinical efficacy of single port video-assisted thoracoseopic lobectomy （SPVATS） for the treatment of lung cancer. Methods Clinical data of 96 patients undergoing SPVATS were retrospectively analyzed. All the cases were diagnosed as malignant lesion. Totally 56 and 40 patients were male and female repectively. Twenty-five tumors located in the upper lobe of the right lung,3 in the middle lobe of right lung,16 in the inferior lobe of right lung,24 in the upper lobe of the left lung and 28 in the inferior lobe of left lung. All patients accepted lobectomy and systemic lymphadenectomy. Results The operation was completed successfully in 96 cases. No conversion to open thoracotomy occurred. One auxiliary port was established in 2 eases separately due to severe pleural adhesion. No blood transfusion was needed during the operation. The operative duration was 80 - 190 min （ average： 130 min ）. The intraoperative blood loss was 60 - 300 ml （ average ： 100ml ）. The hospital stay was 3 - 14 days （ average ： 6.5 days）. The number of lymph nodes removed during operation was 11 -32 （average： 17）. Continuous air-leak was found in 2 cases and pleural effusion in 5 cases after operation. Conclusion SPVATS has the advantages of less trauma, rapid recovery, shorter hospital stay and dramatical removal of lymph nodes, and can be taken as the first selection for surgical dissection of lung cancer.