胸腔镜辅助小切口治疗多形性肺癌28例疗效观察  

Video-assisted Mini-thoracoscopy for Complete Resection of 28 Cases of Pleomorphic Carcinoma of the Lung

作　　者：成向阳[1] 熊信国[1] 邱源[1] 刘君[1] 陈汉章[1] 何建行[1] 

机构地区：[1]广州医学院第一附属医院胸外科,广州呼吸疾病研究所,广州510120

出　　处：《中国肺癌杂志》2010年第8期813-816,共4页Chinese Journal of Lung Cancer

摘　　要：背景与目的胸腔镜辅助小切口(video-assisted mini-thoracoscopy,VAMT)下完成肺叶切除已有二十年的历史,具有创伤小、术后疼痛轻、肺功能损失少、恢复快等优点,是目前微创胸部外科的发展趋势。本研究旨在探讨胸腔镜辅助小切口肺叶切除术在多形性肺癌治疗中的应用价值。方法应用VAMT行根治性肺叶切除术治疗28例多形性肺癌。采用常规器械与胸腔镜器械相结合直视操作处理肺血管、支气管行肺叶切除,胸腔镜、直视下行纵隔、肺门区淋巴结清扫。结果 28例均获成功。无围手术期死亡,术中出血量200mL-450mL,平均300mL;胸管留置时间3d-8d,平均5d,术后总引流量300mL-800mL,平均460mL;术后住院7d-14d,平均12d。随访28例,其中2例患者于术后2个月死亡,其余患者生存均超过1年,3年生存率为60.7%(95%CI:40.3%-81.1%)。结论 VAMT治疗多形性肺癌近期疗效良好,既发挥了微创外科的优越性,又达到了传统开胸手术安全、可靠的效果,清扫淋巴结符合肿瘤手术原则,有很好的应用前景。Background and objective Video-assisted mini-thoracoscopy （VAMT） has been used for pulmonary lobectomy for 20 years,which has many merits including small wound,less pain and quick recovery.VAMT is the tendency of pectoral minimally invasive surgical treatment.The aim of this study is to evaluate the efficacy of video-assisted mini-thoracoscopy （VAMT） for radical resection of pleomorphic carcinoma of the lung.Methods Complete resection of pleomorphic carcinoma of the lung was performed on 28 patients by VMAT.A 1.5 cm and a 6 cm to 8 cm incision was made during the operation.Both standard surgical instruments and thoracoscopic set were used to treat the pulmonary vessels,perform lobotomy,and remove the lymph nodes in the mediastinum and pulmonary portal.Results The operation was completed in all of the cases.No peri-operative death occurred.The total volume of hemorrhage was 200 mL to 450 mL （mean,300 mL）.The patients received chest drainage for 3 to 8 days after the operation （mean,5 d）.The time in hospital was 7 d-14 d （mean,12 d）.Five-year overall survival and disease-free survival were 39.2% and 47.1%,respectively.Follow-up was available in all 28 patients for up to 2 to 91 months.Among the 28 cases,only 2 patients died 2 months after the operation,the rest all live up over 1 year.3-year survival rate was 60.7% （95%CI： 40.3%-81.1%）.Conclusion VAMT is effective for radical resection of pleomorphic carcinoma of the lung in a short term.Combination the superiority of traditional procedure and VATS,so VAMT is safe and reliable for radical resection of pleomorphic carcinoma of the lung.

关 键 词：胸腔镜辅助小切口手术 多形性肺癌 根治术 

分 类 号：R734.2[医药卫生—肿瘤]