单孔胸腔镜手术在前纵隔肿瘤切除中的临床应用

Resection of anterior mediastinal tumors via uniportal video-assisted thoracoscopic surgery techniques

目的对单孔电视胸腔镜(video-assisted thoracoscopic surgery,VATS)前纵隔肿瘤切除术的临床效果进行初步评估,探讨其可行性和安全性。方法回顾分析2015年7月—2016年7月在海军总医院胸外科接受单孔VATS手术的前纵隔肿瘤病例24例,对术中出血量、手术时间、中转率、术后并发症、术后住院时间、围手术期病死率等进行汇总分析。结果手术时间26~240(66.4±18.2)min,术中出血量20~3 100(112±26.9)mL,术中发生严重并发症2例(8.3%)。术后住院时间3~15(6.3±2.3)d,术后无严重并发症或围手术期死亡病例。结论单孔VATS前纵隔肿瘤切除术是一种安全、可行的手术方法,具有创伤小、疼痛轻、恢复快、切口美观等优点,值得在临床进一步推广应用。

Objective To evaluate the outcomes of uniportal video-assisted thoracoscopic surgery（VATS） in the surgical treatment of anterior mediastinal tumors.Methods From July 2015 to July 2016,medical data of 24 patients,including operation time,intra-operative blood loss,rate of transferring to thoracotomy or sternotomy,post-operative morbidity and mortality,post-operative hospital stay time,etc.undergoing uniportal VATS resection of anterior mediastinal tumors in the Thoracic Department of Navy General Hospital were retrospectively reviewed.Results An operative time 26—240（66.4±18.2） min and an intra-operative blood loss 20—3 100（112±26.9）mL were recorded.There were 2 intra-operative severe complications in total,while there was no post-operative severe complication or death happened.The post-operative hospital stay time was 3—15（6.3±2.3） d.Conclusion Anterior mediastinal tumors can be managed via uniportal VATS successfully and safely,presenting outstanding advantages of more minimal invasiveness,faster post-operative recovery and better cosmetic incision,which is worth of broad clinical application.