经左胸入路电视胸腔镜手术治疗偏向左侧胸腔胸腺肿瘤的体会  

Left side approach for video assisted thoracic surgery in thymic tumor

作　　者：金璐明[1] 李运[2] 陈应泰[1] 崔健[1] 黄宇清[1] 刘军[2] 

机构地区：[1]北京市海淀医院胸外科,100080 [2]北京大学人民医院胸外科暨胸部微创中心

出　　处：《疑难病杂志》2014年第7期680-682,共3页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的探讨经左胸入路电视胸腔镜手术(VATS)治疗偏向左侧胸腔胸腺肿瘤的可行性。方法 2004年2月—2013年2月胸腔镜胸腺切除手术200例,经左胸入路电视胸腔镜胸腺切除手术42例(左胸入路组)。患者术中均采用右侧卧位,采用全身麻醉,健侧单肺通气,通过前侧操作孔切除胸腺并切断左侧胸腺静脉,术后经左胸腔留置引流管1根。经右胸入路(右胸入路组)患者158例,比较2组临床资料。结果 42例患者均手术顺利,无严重并发症及围手术期死亡病例。单纯胸腺切除术36例,胸腺扩大切除术6例,其中因肿瘤侵犯周围器官中转开胸4例,平均手术时间(118.3±23.7)min,平均术中出血(99.7±58.3)ml。术后随访(35.5±22.2)个月,均未见肿瘤复发。与右胸入路组比较,左胸入路病变最大径明显大(t=3.592,P<0.05)。结论经左胸入路电视胸腔镜胸腺切除术有效可行,是左侧胸腔胸腺肿瘤首选的手术切除方式。Objective To evaluate the feasibility of the left thoracic approach video-assisted thoracoscopic operation（VATS） toward thymoma in the left pleural cavity.Methods From 2004 February to 2013 February,200 cases of thoracoscopic thymectomy operation were enrolled,through left thoracic approach video-assisted thoracoscopic thymectomy operation was 42 cases（left thoracic approach group）.The patients in the right lateral decubitus,general anesthesia is used,the contralateral one lung ventilation,through the front side hole thymectomized and cut off the left thymic vein,after operation with1 tube for left pleural indwelling drainage.Through right thoracic approach（right thoracic approach group） in 158 cases,compare the clinical data of the 2 groups.Results 42 patients received successful operation,no serious complications and peri-operation period death cases.Simple thymus resection in 36 cases,thymus expand resection in 6 cases,the tumor invasion of adjacent organs for thoracotomy in 4 cases,the average operation time was（118.3± 23.7） min,the average intraoperative bleeding（99.7±58.3） ml.Postoperative follow-up（35.5 ±22.2） months,showed no tumor recurrence.Compared with the right thoracic approach group,left thoracic approach the maximum diameter of the lesions was significantly greater（t =3.592,P〈 0.05）.Condnsioii Through left thoracic approach video-assisted thoracoscopic thymectomy is effective,is the frist choice of left pleural thymoma resection.

关 键 词：左侧入路 电视胸腔镜 胸腺肿物切除术 

分 类 号：R736.3[医药卫生—肿瘤]