单孔全胸腔镜下肺叶切除术治疗早期肺癌  

Clinical Observation of Uniport Thoracoscopic Lobectomy for Early Stage Lung Cancer

作　　者：张明[1] 吴奇勇[1] 王勇[1] 钟斌[1] 张科[1] 袁俊强[1] 王烨铭[1] 

机构地区：[1]南京医科大学附属常州市第二人民医院胸心外科,常州213003

出　　处：《中国微创外科杂志》2016年第12期1125-1126,1130,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨单孔全胸腔镜下肺叶切除术治疗早期非小细胞肺癌的安全性、可行性。方法回顾性分析2015年3月-2016年6月28例早期非小细胞肺癌行单孔全胸腔镜下肺叶切除术的临床资料。患侧第4或第5肋间腋中线与腋前线之间4-5 cm切口,全胸腔镜下完成肺叶切除和肺门、纵隔淋巴结清扫。结果 28例均于全胸腔镜下完成手术,无中转开胸,无围术期死亡。手术时间（154.7±45.3）min,术中出血量（126.3±58.6）ml,清扫淋巴结（12±5）枚。无二次开胸,无严重并发症。术后留置胸腔引流（3.2±1.5）d。术后疼痛轻,仅5例需服用镇痛药。术后住院时间（6.5±4.3）d,均顺利出院。p TNM分期ⅠA期6例,ⅠB期10例,ⅡA期7例,ⅡB期5例。随访时间2-15个月,（6.8±3.6）月,无复发转移。结论单孔全胸腔镜下肺叶切除术治疗早期非小细胞肺癌安全可行,近期效果良好。Objective To evaluate the safety and feasibility of uniport thoracoscopic lobectomy in the treatment of early stage non-small cell lung cancer. Methods From March 2015 to June 2016,clinical records of 28 patients with early stage non-small cell lung cancer who underwent uniport thoracoscopic lobectomy were retrospectively reviewed. A 4- 5 cm incision,between the anterior axillary line and the midaxillary line,was made at the fourth or fifth intercostal space to insert the thoracoscope for lobectomy and systemic lymphnodes resection. Results All the patients underwent surgery successfully without conversion to thoracoctomy. No mortality,secondary operation or severe complications were observed during perioperative period. The mean operative time and intraoperative bleeding were（ 154. 7 ± 45. 3） min and（ 126. 3 ± 58. 6） ml,respectively. The mean number of lymph nodes resected was（ 12 ± 5） nodes. The mean chest tube drainage duration and postoperative hospital stay were（ 3. 2 ± 1. 5） days and（ 6. 5 ± 4. 3）days,respectively. Owing to light postoperative pain,only 5 patients underwent analgesic therapy. All the patients were discharged uneventfully. According to the pathological TNM stage,6 patients were stage ⅠA,10 patients were stage ⅠB,7 patients were stageⅡA,and the other 5 patients were stage ⅡB. Patients were followed up for 2 to 15 months,the mean follow-up period being（ 6. 8 ±3. 6） months. No recurrence or metastasis was observed during the follow-ups. Conclusion The uniport thoracoscopic lobectomy,with a good short-term effect,is a feasible and safe technique for the treatment of early stage non-small cell lung cancer.

关 键 词：单孔 胸腔镜肺叶切除术 非小细胞肺癌 

分 类 号：R734.2[医药卫生—肿瘤]