单操作孔全胸腔镜肺叶切除术的临床应用  

Clinical application of single utility port complete thoracoscope lobotomy

作　　者：刘永靖[1] 于奇[1] 缪军[1] 陶宇[1] 彭磊磊[1] 戚胜波[1] 吕本博[1] 

机构地区：[1]解放军第105医院胸外科,安徽合肥230031

出　　处：《临床肺科杂志》2014年第10期1855-1857,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的总结单操作孔全胸腔镜肺叶切除术的临床应用体会。方法 2012年3月至2014年5月共施行126例全胸腔镜下肺叶切除术。术中取腋中线第7肋间切口约1.5 cm作为胸腔镜观察孔,腋前线第4,5肋间4～5 cm切口作为主操作孔。所有手术均通过主操作孔在胸腔镜下完成,肺癌患者同时行系统淋巴结清扫。结果全组平均手术时间110±25 min（85-150 min）,平均出血70±10 ml（20-150 ml）,术后胸引管平均引流量320±60 ml（200-550 ml）,术后胸引管平均保留时间4.2±1.6 d（3-6 d）,术后住院时间平均7.7±2.5 d（5-10 d）。所有患者均康复出院,未发生严重并发症及围术期死亡,中转开胸13例。结论术前筛选把握适应症,术中进行胸腔镜探查,细致谨慎地镜下操作,单操作孔全胸腔镜肺叶切除术安全可靠,且具有创伤小,出血少,恢复快的优势。Objective To summarize the clinical application experience of single utility port complete thoracoscope lobotomy. Methods From March 2012 to May 2014,126 cases of video-assisted thoracoscope lobotomy were completed in our department. An approximately 1. 5cm surgery incision was taken at the 7th intercostal mid-axillary line as the thoracoscope observation hole and an approximately 4-5cm incision at the 4th or 5th intercostal as the primary operation hole. All surgeries were completed by thoracoscope surgery. At the same time,they were given systematic lymph node dissection. Results The average operative time was 110 ± 25min（ 85- 150 min）,the average amount of bleeding was 70 ± 10 ml（ 20- 150 ml）,the average chest lead liquid of post-operative was 320 ± 60 ml（ 200-550 ml）,the chest tube retention time of post-operative was 4.2 ±1.6 d（ 3-6 d）,and the average duration of hospital stay was 7. 7 ± 2. 5 d（ 5- 10 d）. All patients recovered smoothly,and there was no serious perioperative complication and death occurred. 13 cases opened chest because of lymphatic and vascular dense adhesion. Conclusion Preoperative screening cases should grasp the operation indications strictly. For single utility port complete thoracoscope lobotomy,it is a safe method with less traumatic,less bleeding,and faster recovery.

关 键 词：单操作孔 全胸腔镜 肺叶切除术 肺癌 

分 类 号：R734.2[医药卫生—肿瘤]