单孔胸腔镜下双肺多发结节的同期手术的临床研究

Clinical study on single-stage bilateral pulmonary resections by uniportal video-assisted thoracic surgery for multiple small nodules

目的总结单孔胸腔镜下双肺多发结节同期手术的临床经验。方法回顾分析2016年6月~2018年9月哈尔滨医科大学附属肿瘤医院胸外科25例双肺结节患者同时行单孔胸腔镜下双侧手术患者的临床资料。患者均根据纳入标准经术前评估。考察手术及围手术期相关指标(手术时间、病变直径、术中出血量、淋巴节转移情况、术后引流是境、住院时间)、手术方式及术中、术后的并发症;对病理结果、临床疗效,手术相关并发症与手术术式的关联进行分析。结果所有手术顺利完成,术中出血量(115.2±89.7)mL,手术时间(313.4±111.7)min,术后引流时间(6.0±2.3)d,术后住院时间6~19(9.7±3.2)d,住院期间无死亡病例,21例(84.6%)患者恢复顺利,心律失常3例,冠心病1例。结论经筛选的双肺结节患者同期行单孔胸腔镜下双肺同期手术是安全可行且治疗效果满意。

Objective To summarize the clinical experience of simultaneous surgical treatment of multiple nodules under uniportal video-assisted surgery. Methods A retrospective analysis of 25 patients with bilateral pulmonary nodules underwent uniportal video-assisted surgery in the Department of Thoracic Surgery from Harbin Medical University Cancer Hospital from June 2016 to September 2018 was performed. The patients were evaluated preoperatively according to the inclusion criteria. The related indicators of surgery and perioperative period(operation time, lesion diameter, intraoperative blood loss, lymph node metastasis, postoperative drainage time, hospital stay), surgical methods, and intraoperative and postoperative complications were investigated;The pathological results, clinical efficacy, and the correlation between surgery-related complications and surgical procedures were analyzed. Results All the operations were completed smoothly. The intraoperative blood loss was(115.2±89.7)mL, the operation time was(313.4±111.7)min, the postoperative drainage time was(6.0±2.3) days, and the postoperative hospital stay was(9.7±3.2)d, there were no deaths during hospitalization, and 21 patients(84.6%) recovered smoothly, 3 patients had arrhythmia, 1 patient had coronary heart disease. Conclusion Simultaneous uniportal video-assisted surgery in the selected patients with bilateral pulmonary nodules is safe, feasible and satisfactory.