电视胸腔镜手术在纵隔肿瘤诊治中的应用  

Application experience of video-assisted thoracic surgery for mediastinal tumors

作　　者：叶俊[1] 杨劼[1] 古卫权[1] 王飞[1] 杨胜利[1] 肖叶[1] 罗灵均 张小文[1] 

机构地区：[1]广东省佛山市第一人民医院胸外科,佛山528000

出　　处：《中国肿瘤临床与康复》2015年第1期59-61,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨电视辅助胸腔镜手术（VATS）在纵隔肿瘤临床诊治中的安全性和有效性。方法回顾性分析2005年6月至2013年10月间收治的115例原发性纵隔肿瘤患者的临床资料,其中男性74例,女性41例,年龄17~75岁。肿瘤平均最大直径4.5 cm。前纵隔肿瘤78例,中纵隔肿瘤3例,后纵隔肿瘤34例。手术均采用气管插管静吸复合全麻。结果 115例患者中,有111例患者行肿物完整切除,4例仅行活检手术。102例患者行VATS切除,91例采用3个套管口,11例采用2个套管口,9例术中延长切口8~10 cm完成手术。手术时间45~240 min,平均90 min。术中出血50~1200 ml,平均100 ml。术后留置胸管引流2~6 d,平均3.5 d,术后住院7~16 d,平均8 d。所有患者手术及恢复顺利,无围术期死亡。结论 VATS治疗纵隔肿瘤安全、微创、有效,在临床上值得推广。Objective To summarize the application experience of video-assisted thoracic surgery（VATS） in the treatment of primary mediastinal tumor,and explore the safety and efficacy.Methods From June 2005 to October 2013,115 cases of primary mediastinal tumor patients treated in the First People＇s Hospital of Foshan City were enrolled in the study,including 74 males and 41 females.The average age of the patients was 38.3 yr;The average tumors size was 4.5 cm.And there were 78 anterior mediastinal tumors,3 middle mediastinal tumors,34 posterior mediastinal tumors.All surgeries were completed under the combined intravenous and inhalation anesthesia.Results Four cases of lesion biopsy were performed;One hundred and eleven operations were successfully completed,of which 102 cases were treated with thoracoscopic surgery,and 9 cases were performed open conversions by extending the incision to 8 ~ 10 cm.91 of them require 3 ports,11 of them require 2 ports;the operation time was 45 ~ 240 min,（mean90 ± 35 min）;the blood loss was 50 ~ 1200 ml,（mean100 ± 65 ml）;thoracostomic drainage tube was placed for 2 ~ 6days,（mean 3.5 ± 1.5days）,the postoperative hospital stay was 7 ~ 16 days,（mean8 ± 2.5d ays）;All cases were cured and there was no perioperative death.Conclusion VATS for mediastinal tumor is safe,minimally invasive and effective.It is worthy to be applied widely.

关 键 词：纵隔肿瘤 胸腔镜手术 原发性 

分 类 号：R734.5[医药卫生—肿瘤]