双孔胸腔镜肺段切除术56例

Two-port Video-assisted Thoracoscopic Lung Segment Resection:Report of 56 Cases

目的探讨双孔胸腔镜肺段切除术的安全性及可行性。方法回顾性分析2015年1月～2017年12月我院56例双孔胸腔镜肺段切除术资料,术前检查示病变位于右上肺后段12例、尖前段3例,右下肺背段10例、基底段4例,左上肺舌段9例、尖后段4例,左下肺背段11例、基底段3例,直径0.9～2.0 cm,平均1.5 cm。结果 56例均获成功,无中转开胸,无中转肺叶切除,术后无严重并发症发生。术后病理结果显示肺良性疾病34例,原发性非小细胞肺癌15例,肺转移瘤7例。手术时间130～265 min,平均142 min;术中出血量30～510 ml,平均135 ml;术后胸腔引流时间3～10 d,平均5.8 d;术后住院时间4～12 d,平均7.6 d。34例良性病变随访5～24个月,平均12个月,无并发症发生。15例肺癌随访3～34个月,平均23个月,均无复发、转移。结论对于局限靠近肺门的良性病变、孤立性肺转移瘤和部分Ⅰa期非小细胞肺癌,双孔胸腔镜肺段切除术是一种安全可靠的手术方式。

Objective To explore the safety and feasibility of two-port thoraeoseopie lung segment resection. Methods A total of 56 patients who received two-port video-assisted thoraeoseopie surgery （VATS） lung segment resection from January 2015 to December 2017 were collected retrospectively. Among these patients, lesions were located in posterior segment of upper right lung in 12 cases, in apieoanterius segment of upper right lung in 3 cases, in dorsal segment of lower right lung in 10 cases, in basal segment of lower right lung in 4 cases, in lingular segment of upper left lung in 9 cases, in apieoposterius segment of upper left lung in 4 cases, in dorsal segment of lower left lung in 11 cases, and in basal segment of lower left lung in 3 cases. The diameter of tumor was 0.9 - 2.0 em （ mean, 1.5 cm）. Results All the 56 cases received surgery successfully, without conversion to thoraeotomy or lobeetomy. No serious complications were observed among these patients. Pathological results showed 34 cases of puhnonary benign diseases, 15 cases of primary non-small cell lung cancer （NSCLC） and 7 cases of lung metastases tumor. The operative duration was 130 - 265 min （ mean, 142 min）. The bleeding volmne was 30 - 510 ml （ mean, 135 ml）. The thoracic drainage time was 3 - 10 days （ mean, 5.8 days）. The postoperative hospitalization time was 4 - 12 clays （ mean, 7.6 days）. The 34 patients with benign tmnors were followed up for 5 -24 months, with an average of 12 months, and no complications were observed. The 15 patients with lung cancer were followed up for 3 - 34 months, with an average of 23 months, and none suffered recurrence or metastasis. Conclusion Two-port video- assisted thoraeoseopie lung segmenteetomy is safe and feasible for benign lesions near the hilton of the lung, isolated lung metastases lesions, and some I a stage NSCLC patients.