单孔胸腔镜在早期非小细胞肺癌手术中的临床应用  

Clinical Application of Single Hole Thoracic Cavity in Patients With Early Stage Non Small Cell Lung Cancer

作　　者：曹纪伟[1] 朱红军[1] 韩玉龙[1] 曹志坤[1] 朱富国[1] 

机构地区：[1]商丘市第一人民医院胸外科,河南商丘476100

出　　处：《中国继续医学教育》2016年第26期81-83,共3页China Continuing Medical Education

摘　　要：目的 探讨单孔胸腔镜在早期非小细胞肺癌手术中的临床价值及安全性。方法 选取2014年12月~2015年7月于我院接受单孔胸腔镜行肺叶切除术和系统性淋巴结清扫术治疗早期非小细胞肺癌患者21例,其中左肺上叶8例,右肺下叶6例,左肺上叶3例,右肺上叶3例,右肺中下叶1例。所有手术操作均在单孔胸腔镜下完成,单孔在腋前线第5肋间,大小约3.0 cm。结果 （1）所有患者均在单孔胸腔镜下完成肺叶切除术加系统性淋巴结清扫,术中无增加第2个操作孔或者中转开胸者。（2）手术时间150~260 min,平均（210.45±25.54）min;术中出血量139~458 ml,平均（290.85±40.24）ml。术后住院时间6~12 d,平均（9.00±1.14）d;术后送检淋巴结6~16枚,平均（10.24±2.10）枚。（3）术后未见无肺不张、肺部感染、出血、二次开胸等并发症的发生,21例患者术后均未见剧烈疼痛,3例出现中度疼痛,给予镇痛泵止痛。结论 单孔胸腔镜手术治疗早期非小细胞肺癌安全、可靠,是一种更加微创的手术方式。Objective To investigate the clinical value and safety of single hole thoracic cavity in patients with early stage non small cell lung cancer. Methods 21 cases single hole cavity mirror lobectomy and lymph node dissection in the treatment of early non small cell lung cancer in our hospital from December 2014 to July 2015 were selected, among of them left upper lobe in 8 cases, right lower lobe in 6 cases, left upper lobe in 3 cases, right upper lobe in 3 cases, right lower lobe in 1 cases. All operations were completed in the single hole thoracoscopic single hole, the fifth intercostal space in the anterior axillary line, the size of about 3.0 cm. Results （1） All of the patients were under the single port thoracoscopy completion lobectomy with systematic lymph node dissection and surgery without increase in the second operating hole or transit in. （2） The operation time was 150 - 260 min, the average （210.45±25.54） min, intraoperative blood loss was 139--458 ml, the average （290.85±40.24） ml. Postoperative hospitalization time was 6~12 d, the average （9.00±1.14） d, postoperative from lymph nodes in 6~16, the average （10.24±2.10）. （3） The postoperative no atelectasis, pulmonary infection, bleeding, secondary thoracotomy and other complications occurred; 21 patients had no severe pain, 3 cases had moderate pain, giving analgesic pump pain. Conclusion The safety, reliability and safety of the treatment of early non small cell lung cancer with single hole thoracic cavity is a more minimally invasive surgery method.

关 键 词：单孔胸腔镜 非小细胞肺癌 早期 

分 类 号：R734[医药卫生—肿瘤]