两孔法胸腔镜手术治疗胸部良性疾病87例分析  

Preliminary discussion of two-port video-assisted thoracoscopic surgery for 87 cases with benign thoracic diseases

作　　者：雷霆[1] 李继良[1] 

机构地区：[1]大连医科大学附属第一医院胸外科,辽宁大连116011

出　　处：《中国内镜杂志》2011年第12期1278-1280,1283,共4页China Journal of Endoscopy

摘　　要：目的探讨两孔法电视胸腔镜手术治疗胸部良性疾病的手术操作和临床应用价值。方法 2009年10月～2011年2月,该科开展两孔法胸腔镜治疗胸部良性疾病患者共87例。其中包括肺部良性疾病24例(肺叶切除9例、肺楔形切除15例)、气胸32例、纵隔肿瘤20例、食管疾病11例。均为完全胸腔镜操作。结果全部患者手术过程顺利,手术时间为(117.6±22.4)min,术中出血(112.5±36.2)mL,术后住院时间为(5.6±2.2)d,胸腔闭式引流管拔出时间(4.8±1.7)d,手术费用与传统胸腔镜相当。无术中输血,中转开胸2例,无严重手术并发症,无围手术期死亡。患者术后背部疼痛与感觉异常显著减轻。结论两孔法胸腔镜治疗胸部良性疾病安全、可靠,患者痛苦更小,术后恢复快。较单操作孔胸腔镜手术操作更便利,扩大了手术适应证,可作为胸部大多数良性疾病的首选手术方式。Objective To study the operative skills and clinical value of two-port video-assisted thoracoscopic surgery （VATS） for benign thoracic diseases.Methods Two-port VATS was performed for benign thoracic diseases in 87 patients which included 24 with benign lung diseases,32 with pneumothorax,20 with benign mediastinal tumors and 11with esophageal diseases from October 2009 to February 2011 in our department.Results All the operations were finished smoothly.The mean operative time was （117.6±22.4） min.The average blood loss was （112.5±36.2） mL.The postoperative hospital stay was （5.6±2.2） d.The thoracic drainage time was （4.8±1.7） d.The procedure was successful in all patients with only two patients transferred to thoracotomy.All patients recovered uneventfully with no severe postoperative complications and no perioperative death occurred.The patient＇s back pain and the abnormal feelings after the operation were significantly reduced.Conclusion The operative procedure is safe and reliable for the treatment of benign thoracic diseases by two-port VATS.The operation of two-port VATS was more convenient than that of the single-port VATS.With more minimal operative invasiveness and more rapid postoperative recovery,it can be the first choice for most benign thoracic diseases.

关 键 词：两孔法 电视胸腔镜 胸部良性疾病 

分 类 号：R655[医药卫生—外科学]