全胸腔镜下解剖性肺段切除术在GGO中的应用  

Application of complete video-assisted thoracoscopic anatomic segmentectomy for diagnosis and treatment of pulmonary ground-glass opacity

作　　者：麻成方[1] 李绍鹏[1] 李志华[1] 魏春勇[1] 汪礼旭[1] 洪琼川[1] 

机构地区：[1]深圳市龙岗中心医院(深圳市第九人民医院)心胸外科,广东深圳518116

出　　处：《临床肺科杂志》2015年第6期1088-1091,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的：探讨全胸腔镜下解剖性肺段切除术诊治肺部磨玻璃样阴影（ GGO）的可行性及应用价值。方法回顾性分析2008年7月至2013年12月间39例GGO患者经胸腔镜肺段切除术治疗的临床资料。切除部位包括左肺上叶尖后段4例、固有段4例、前段1例、舌段6例,左肺下叶背段5例、基底段4例；右肺上叶尖段、前段、后段各1例,右肺下叶背段7例、基底段5例。术中标本送快速冰冻病理检查,若为良性则结束手术；恶性肿瘤患者清扫淋巴结4～7（4．8±0．2）组。结果全组手术顺利,无中转开胸。手术时间90～310（165±52） min,术中出血量30～200（67．5±12．7） ml,清扫淋巴结4～14（11．7 ± 0．4）枚,无手术死亡及并发症,术后胸腔引流时间3～8（3．8±0．5）d。术后患者均顺利恢复,对肿瘤患者术后随访3～9个月内暂无复发、转移。结论全胸腔镜下解剖性肺段切除术诊治GGO是安全可行有效的,进一步降低了创伤,具有良好的应用价值。Objective To evaluate the clinical feasibility and application of complete video-assisted thoraco-scopic surgery （ VATS） anatomic segmentectomy for diagnosis and treatment of ground-glass opacity. Methods The clinical data of 39 ground-glass opacity cases underwent VATS anatomic segmentectomy were retrospectively analyzed. The locations of resected segments included 4 apical segments, 1 anterior segments, 4 trisegments, 6 lingular segments, 5 superior segments and 4 basement segments in the left side;and 1 anterior segment, 1 posterior segments, 1 apical segments, 7 superior segments and 5 basement segments in the right side. During operation, the fast patho-logic examination was carried out to diagnose specimens. Results All of the 39 patients received complete VATS anatomic segmentectomy successfully. The operation time was 90～310（165 ± 52） min, and intraoperative blood loss was 30～200 （67. 5 ± 12. 7） ml. Patients with lung cancer received 4～7 （4. 8 ± 0. 2） stations of lymph node dissection and the number of lymph node dissection was 4～14 （11. 7 ± 0. 4） for each patient. There was no in-hospital death or postoperative complication. Postoperative thoracic drainage time was 3～8（3. 8 ± 0. 5） days. All the patients were discharge successfully. Lung cancer patients were followed up for 3～9 months without recurrence or metastasis. Conclusion Complete VATS anatomic segmentectomy is a safe and feasible surgical procedure for diagnosis and treatment of ground-glass opacity.

关 键 词：胸腔镜手术 解剖性肺段切除术 肺部磨玻璃样阴影 

分 类 号：R734.2[医药卫生—肿瘤]