支气管优先处理法在胸腔镜肺上叶切除术中的应用

Application of Bronchus-first Method in Video-assisted Thoracoscopic Lobectomy of Upper Lobe Resection

目的探讨支气管优先处理在胸腔镜肺上叶切除术中的应用价值。方法回顾性分析我院2016年3月~2018年12月胸腔镜肺上叶切除术69例资料,其中右肺上叶36例,左肺上叶33例。均采用单操作孔胸腔镜手术,优先离断支气管。结果中转开胸3例,其余手术顺利。手术时间(132.8±31.6)min,出血(60.7±36.0)ml。术后心律失常5例,肺部感染1例,切口愈合不良2例,均康复出院,未出现严重并发症。良性病变12例,恶性肿瘤57例。结论支气管优先处理法适用于胸腔镜肺上叶切除,手术安全可行,同时简化手术操作,减少腔镜下切割缝合器的使用,可以成为胸腔镜肺上叶切除的一种手术顺序。

Objective To explore the feasibility of bronchus-first method in video-assisted thoracoscopic surgery(VATS)of upper lobe resection.Methods A retrospective analysis was made on 69 cases of VATS of upper lobe resection from March 2016 to December 2018,including 36 cases of right upper lobe resection and 33 cases of left upper lobe resection.All the cases were given single utility port VATS,and the bronchus was stapled first during surgery.Results All the surgeries were carried out safely,with conversion to thoracotomy in 3 cases.The average operation time was(132.8±31.6)min and the average amount of bleeding was(60.7±36.0)ml.There were 5 cases of arrhythmia,1 case of pneumonia,2 cases of bad healing incision after surgery,all of which were recovered and discharged after appropriate treatment without serious complications.There were 12 cases of benign diseases and 57 cases of malignant diseases.Conclusions It is safe and feasible to use bronchus-first method for upper lobectomy of VATS.It can simplify the operation and reduce the use of endoscopic stapler.It is an operation sequence of upper lobectomy under thoracoscopy.