摘要
目的探讨单孔胸腔镜下亚肺叶切除的安全性。方法 2017年1～12月我科对68例术前诊断为肺结节行单孔胸腔镜下亚肺叶切除。44例肺结节先行单孔胸腔镜下肺结节楔形切除,术中标本送快速病理,若快速病理提示为微浸润腺癌,行相应解剖性肺段切除,进一步行纵隔淋巴结清扫;24例肺结节因位置较深,直接行相应肺段解剖性肺段切除,标本送快速病理,若快速病理为微浸润腺癌,行淋巴结清扫。结果 37例行非解剖性肺楔形切除,手术时间(68.9±8.8)min,术中出血量(61.9±12.4)ml;31例行解剖性肺段切除术,手术时间(83.3±11.3)min,术中出血量(67.1±16.0)ml。无围手术期死亡,10例发生并发症(肺部感染5例,肺不张2例,胸腔积液3例),经治疗后均治愈出院,并发症发生率14.7%。68例术后6个月随访,复查胸部CT均未见肺结节、胸腔积液及肺不张。结论单孔胸腔镜亚肺叶切除治疗肺部小结节在技术上是安全可靠的,是一个值得推广的手术方式。
Objective To assess the safety of uniportal thoraeoseopie sublobeetomy. Methods Sixty-eight patients preoperattvly diagnosed as pulmonalT nodules underwent sublobeetomy under uniportal thoraeoseope from January to December 2017. A total of 44 eases of pulmonalT nodules were removed by uniportal thoraeoseopie wedge resection, and the specimens were sent to rapid pathology, such as rapid pathological hints for mieroinvasive adenoeareinoma（MIA） , then the corresponding segment resection and mediastinal lymph node dissection were performed. In another 24 eases of lung nodules, the corresponding segment of lung was removed directly because of the deep location. The specimen was sent for rapid pathology. If the rapid pathology showed a MIA, mediastinal lymph node dissection was performed. Results In 37 eases of non-anatomic wedge resection, the operation time was （68.9 ± 8.8） rain and the amount of intraoperative bleeding was （61.9 ± 12.4） ml. In 31 eases of anatomic segmenteetomy, the operation time was （83.3 ± 11.3） rain and the amount of intraoperative bleeding was （67. 1 ± 16.0） rain. No perioperative deaths occurred. There were 10 eases of complications （ puhnonary infection in 5 eases, ateleetasis in 2 eases, and pleural effusion in 3 eases）. The complication rate was 14.7% （10/68）. After treatment, they were cured and discharged. The 68 patients were followed up postoperatively tor 6 months. There were no puhnonary nodules, pleural ettusion or ateleetasis under the chest CT. Conclusion Uniportal thoraeoseopie sublobeetomy is a safe and reliable technique for the treatment of small puhnonary nodules.
作者
李金友
孙振宇
谢骏
Li Jinyou;Sun Zhenyu;Xie Jun(Department of Thoracic Surgery,Third Affiliated Hospital of Nantong University,Third People＇s Hospital of Wuxi,Wuxi 214000,China)
出处
《中国微创外科杂志》
CSCD
北大核心
2018年第10期904-907,共4页
Chinese Journal of Minimally Invasive Surgery
基金
无锡市卫生和计划生育委员会面上项目(MS201715)
关键词
亚肺叶切除
单孔胸腔镜
肺结节
胸腔镜手术
Sublobeetomy
Uniportal thoraeoseope
Pulmonary nodules
Video-assisted thoraeoseopie surgery
