电视胸腔镜手术在肺切除术中的应用

Video-assisted Thoracoscopic Surgery in Lung Resection

目的 探讨胸腔镜辅助小切口在肺切除术中的应用价值。方法 在第 7肋间腋中线作 1.5cm切口 ,插入胸腔镜。在第 5肋间腋前线和腋中线间作约 6cm小切口 ,行肺切除术 17例 ,其中肺楔形切除术 3例、肺叶切除术 14例。结果 术后 17例中肺癌 14例 (腺癌 12例、鳞癌 2例 ) ,肺炎性假瘤 1例 ,肺结核球 2例 ,PTNM分期包括Ⅰa 9例、Ⅰb 1例、Ⅱa 2例、Ⅱb 2例。随访 5～ 37月 ,除 1例死于肝转移外 ,其余均健在。结论 胸腔镜手术在肺切除术中的应用 ,有利于肺孤立性小结节的诊治 ,可作为早期肺癌外科治疗的一种手段。

objective To study the application value of videoassisted thoracoscopic surgery (VATS) in lung resection.Methods After performing a 1.5 cm incision in the location at 7 intercostal axillary centerline , inserted the videoassisted thoracoscopy.Then the lung resection in 17 patients was performed through a 6 cm small incision between the axillary frontline and laterline.In these patients there were lung wedge resection in 3 cases and lobectomy in 14 cases. The pathological bindings were lung cancer 14 cases(12 cases of glandular cancer, 2 cases of squamouscell cancer), inflammatory pseudotumor of the lung 1 cases and pulmonary Tuberculoma 2 cases. Results All of the 17 cases were survival after operation without blood transfusion.Two cases complicated with pneumonia and 1 with atelectasis postoperatively. Following up 5～37 months, all patients survived except died in liver retastasis. Conclusion The application of videoassisted thoracoscopy in lung resection is to effective in the diagnosis and treatment of the small solitory pulmonary nodule, and it is an approach in surgical treatment of earlier period lung cancer.