单操作孔胸腔镜右肺上叶简约式切除的临床观察

Clinical observation of right upper lobectomy with single utility port video-assisted thoracoscopic surgery

目的探讨单操作孔胸腔镜右肺上叶简约式切除术治疗肺癌的可行性。方法回顾性分析2015年12月至2016年12月采用单操作孔胸腔镜右肺上叶简约式切除术的25例肺癌患者的临床资料,并观察手术时间、失血量、带管时间及住院时间等指标。结果所有患者均在单操作孔下顺利完成手术,平均手术时间为(90±10.6)min,平均失血量为(60±5)ml,平均带管时间为(5±0.5)d,平均住院时间为(9.7±0.5)d。术后4例患者出现肺不张伴肺内感染。结论单孔胸腔镜右肺上叶简约式切除术治疗右肺上叶肺癌,手术方法简便,安全可靠,但需要患者的肺裂分化良好,且术者技巧熟练,值得广泛应用。

Objective To investigate the feasibility of right upper lobectomy with single utility port video-assisted thoracoscopic surgery （VATS） for lung cancer. Methods The clinical data of 25 patients who underwent right upper lobectomy with single utility port VATS from December 2015 to December 2016 were retrospectively analyzed. The operation time, blood loss, extubation time and hospitalization days were observed. Results The procedure was successfully performed in all patients and no patient transferred for open thoracotomy. The mean time of operation was （90±10. 6） rain, and the mean blood loss was （60±5） ml. The mean extubation time was （5±0. 5） d, and the mean hospitalization days was （9. 7±0. 5 ） d. Four patients were suffered from postoperative atelectasis with lung infections. Conclusion The right upper lobectomy with single utility port VATS for lung cancer of right upper lobe is simple, safe and reliable, but it requires good differentiation of lung and surgical skill, and worthy of wide application.