摘要
目的分享单操作孔全胸腔镜肺癌完全切除经验。方法 2011年11月至2014年6月上海市新华医院共对342例患者行单操作孔全胸腔镜下肺癌完全切除术,其中男196例,女146例;手术年龄26-85岁(平均56.42±18.63岁);体重38-88kg(平均61.54±17.72kg),所有患者经左/右侧卧位,于腋中线第7或第8肋间做腔镜孔,腋前线第3-5肋间做2-4cm操作孔,行全胸腔镜病变肺叶切除及常规淋巴结清扫。结果 8例因血管损伤出血转为小切口手术,5例因操作困难增加一个操作孔,其余329例手术均在单操作孔下完成,其中左上肺叶切除75例,左下肺叶切除66例,右上肺叶切除59例,右中肺叶切除46例,右下肺叶切除83例,采集淋巴结9-19(平均13.75±5.62)个,手术时间74-182(平均136.65±45.82)分钟,术中出血40-480(平均130.54±74.42)ml,术后住院时间4-14(平均7.53±3.45)天,住院期间无死亡病例,16例术后合并肺不张、8例合并肺炎经治疗后痊愈,其余均恢复顺利。结论单操作孔全胸腔镜下肺癌完全切除创伤小,恢复快,淋巴结清扫相对困难。
Objective To share the experience of single utility port complete video-assisted thoracoscopic surgery used in lung cancer. Methods From November 2011 to June 2014, a total of 342 patients with lung cancer underwent lobectomy with single utility port complete VATS in Xinhua hospital of Shanghai, including 196 male cases and 146 female cases. They aged from 26 to 85 years old （average 56. 42 ± 18. 63 years old）, and they weighted from 38 to 88kg （average 61. 54 ± 17. 72 kg）. All the patients underwent left/right side lying position. One incision was made in the 7th or 8th intercostal space on the midaxillary line, and another incision of 2-4 cm in the 3-5th intercostal space on the anterior axillary line. Then all of them were given complete video-assisted thoracoscopic lobectomy and conventional lymph node dissection. Results There were 8 cases convert to small incision operation because of vascular injury, and 5 cases needed one more port because of operational difficulties. The remaining 329-case operation were completed under single utility port, including 75 cases of left lower lobe lung cancer, 66 cases of left lower lobe lung cancer, 59 cases of right lower lobe lung cancer, 46 cases of right middle lobe lung cancer and 83 cases of right lower lobe lung cancer. The resection number lymph node were 9-19 （mean 13. 75 ± 5. 62）, the operation time was 74-182 （ mean 136. 65 ± 45. 82 ） minutes, the amount of bleeding in the operation was 40 -480 （mean 130.54 ±74.42） ml, and the postoperative duration of hospital stay was 4-14 （mean 7.53 ±3.45） days. There was no death reported during hospitalization, 16 cases complicated with atelectasis and 8 cases with pneumonia cured after symptomatic treatment. The rest recovered smoothly. Conclusion Single utility port complete video-as-sisted thoracoscopic lobectomy has small trauma and recover quickly, but lymph node dissection is relatively difficult.
出处
《临床肺科杂志》
2015年第6期1006-1008,共3页
Journal of Clinical Pulmonary Medicine
关键词
电视胸腔镜手术
单操作孔
肺叶切除术
外科手术
video assisted thoracoscopic operation
single utility port
lobectomy
surgical operation
