全胸腔镜下全肺切除术的临床分析  

Clinical analysis of pneumonectomy by video-assisted thoracoscopic surgery

作　　者：刘元奇[1] 程远大[1] 高阳[1] 张春芳[1] 

机构地区：[1]中南大学湘雅医院胸外科,长沙410008

出　　处：《中国胸心血管外科临床杂志》2017年第7期538-542,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的探讨胸腔镜下全肺切除术治疗肺部疾病的治疗价值。方法回顾性分析2013年1月至2015年10月在我院胸外科行胸腔镜全肺切除术的34例患者的临床资料及术后随访结果。男26例、女8例,年龄35~69(53.8±7.7)岁。结果全组34例患者中,2例中转腔镜辅助小切口手术,其余32例(良性病变4例,恶性28例)行全胸腔镜手术。平均手术时间(182.5±52.4)min,术中平均出血量(217.1±1 834.8)ml。对于肺癌患者,清扫淋巴结平均5组,平均15.4枚;术后引流时间平均(6.0±1.7)d,术后住院时间平均(7.6±1.8)d;围术期无死亡,11例患者发生术后并发症(34.3%),以肺部感染为主(8例)。随访10(1~21)个月,1例术后2个月发生支气管胸膜瘘,1例术后3个月因心搏骤停猝死,2例患者复发转移分别于术后16个月、17个月死亡。结论胸腔镜下全肺切除术安全且可行,但对肺癌患者其远期疗效尚需进一步研究。Objective To evaluate the validity of video-assisted thoracoscopic surgery （VATS） pneumonectomy in thoracic diseases treatment. Methods We retrospectively analyzed the clinical data of 34 consecutive patients who underwent VATS pneumonectomy in Xiangya Hospital Central South University between lanuary 2013 and October 2015. There were 26 males and 8 females at age of 35-69 （53.8±7.7） years, Results VATS pneumonectomy was completed successfully in 32 patients （5.8% conversion rate）. The average operation time was 182.5±52.4 rain. The average blood loss was 217.1 ± 1 834.8 ml. Chest tube drainage flow was 3-11 （6.0± 1.7） days and postoperative hospital stay was 5-12 （7.6± 1.8） days. Eleven patients got postoperative complications （34.3%）, mainly pulmonary infections. The 32 patients were followed up for 10 （1-21） months. Two patients died of lung metastasis 16 or 17 months after the operation. One patient died of sudden cardiac arrest 3 months after operation. Bronchopleural fistula （BPF） happened in one patient after hospital discharge in 2 months. Conclusion VATS is feasible for pneumonectomy. However, further studies and follow-up are needed to verify the benefits of VATS pneumonectomy for lung cancer.

关 键 词：胸腔镜手术 全肺切除术 肺肿瘤 

分 类 号：R734.2[医药卫生—肿瘤]