摘要
目的:探讨三维互动定量手术规划(3DIQSP)电视胸腔镜下解剖性肺段切除术的手术流程及临床运用价值。方法:分析2018年2月~2018年12月我院胸心外科完成的3DIQSP电视胸腔镜下解剖性肺段切除术的27例患者的病例资料。结果:27例手术均顺利完成,无中转开胸及辅助小切口。手术平均时间150.6±16.6min,术中评价出血量115.6±9.3mL。22例(81.48%)患者术后病检为浸润性腺癌/微浸润性腺癌/原位癌,均为磨玻璃样结节(GGNs),行肺门纵隔淋巴结采样,切除淋巴结4~12枚,平均7.6±1.8枚。无围手术期死亡和二次手术患者。术后胸腔引流时间2~4d,术后住院时间4~8d,平均7.5±0.9d。共切除35个小结节,其中GGNs 33个(94.29%),实性结节2个(5.71%);术后病理诊断高分化腺癌7个,中分化腺癌12个,低分化腺癌1个,微浸润腺癌5个,非典型腺瘤样增生3个,原位癌2个,错构瘤1个(实性结节),肉芽肿性炎改变1个,硬化性肺泡细胞瘤1个(实性结节),弥漫性特发性肺神经内分泌细胞增生1个,纤维增殖灶1个。结论:术前3DIQSP,可降低胸腔镜下肺段切除手术难度,减少手术风险,提高手术效果。
Objective:To investigate the surgical procedure and clinical application value of three-dimensional interactive quantitative surgical planning(3 DIQSP)video-assisted thoracoscopy in anatomic segmentectomy.Methods:A total of 27 patients underwent the 3 DIQSP video-assisted thoracoscopic anatomic pulmonary segmentectomy from February 2018 to December 2018 in our hospital were collected and analyzed.Results:All operation was performed successfully without thoracotomy and auxiliary small incision.The average operation time was 150.6±16.6 min,and the average intraoperative blood loss was 115.6±9.3 mL.Postoperative pathological examinations indicated there were 22 cases of malignant,including infiltrating adenocarcinoma,microinvasive adenocarcinoma and preinvasive carcinoma,which were all manifested ground glass nodules(GGNs),accounting for 81.48% of the total.Hilar mediastinal lymph nodes were sampled and excised from 4 to 12 pieces,with the average of 7.6±1.8 pieces.There were no perioperative death and second operation among all patients.The thoracic drainage time was 2 to 4 d,and the postoperative hospital stay was4 to 8 d,with the average of 7.5±0.9 d.A total of 35 pulmonary nodules were resected,including 33 GGNs(94.29%)and 2 solid nodules(5.71%).The postoperative pathological diagnosis displayed there were 7 cases of high differentiation adenocarcinoma,12 cases of moderately differentiated adenocarcinoma,1 case of poorly differentiated adenocarcinoma,5 cases of minimally invasive adenocarcinoma,3 cases of atypical adenomatous hyperplasia,2 cases of preinvasive carcinoma,and 5 cases of the others.Conclusion:3 DIQSP video-assisted thoracoscopic anatomic pulmonary segmentectomy could reduce operating difficulty,decrease operation risk and improve operation effect.
作者
刘云
张松林
胡旭
Liu Yun;Zhang Songlin;Hu Xu(Department of Cardiothoracic Surgery, Yichang Central People's Hospital, The First College of Clinical Medical Science, China Three Gorges University, Yichang 443003, China)
出处
《巴楚医学》
2019年第3期15-20,共6页
Bachu Medical Journal
关键词
三维互动定量手术规划
肺结节
肺段切除
three-dimensional interactive quantitative surgical planning
pulmonary nodules
segmentectomy
