单操作孔全胸腔镜肺癌根治术124例  

Clinical Study of 124 Cases of Single Utility Port Complete Video-assisted Thoracoscopic Surgery of Lobectomy for Lung Cancer

作　　者：张振龙[1] 潘小杰[1] 郭天兴[1] 欧德彬[1] 黄雪珊[2] 林招贤[1] 

机构地区：[1]福建省立医院胸外科,福州350001 [2]福建医科大学附属协和医院心外科,福州350001

出　　处：《中国微创外科杂志》2017年第9期844-846,共3页Chinese Journal of Minimally Invasive Surgery

基　　金：福建省卫生厅青年基金(2012-01-19)

摘　　要：目的探讨单操作孔全胸腔镜肺叶切除术治疗肺癌的临床应用价值。方法 2015年6月~2016年5月,采用单操作孔全胸腔镜肺叶切除术治疗肺癌124例。手术经一个操作孔和一个观察孔完成,观察孔取腋中线第7肋间,约1.5cm,操作孔取腋前线第4肋间,3~4 cm,术后常规放置1或2根胸腔引流管。结果无围手术期死亡,无中转开胸,无严重并发症发生。手术时间(139.2±43.1)min,术中出血量中位数55 ml(30~200 ml),术中淋巴结清扫(16.9±5.2)枚。术后住院时间(7.7±4.1)d。术后肺不张4例,经加强咳嗽咳痰后1周内均肺复张;1例持续少量漏气,经负压吸引7 d后停止漏气。116例随访2~13个月,(6.8±3.4)月,1例因心律失常术后11个月死亡,其余115例无复发、转移。结论单操作孔全胸腔镜肺叶切除术治疗肺癌安全、可行。Objective To evaluate the c linic al value of single ut ility port complete video-assisted thoracoscopic surgery （VATS） of lobectomy in patients with lung cancer. Methods From June 2015 to May 2 0 1 6 , 124 pa tients underwent lobectomy with single utility port complete VATS. The port for observation （1.5 cm in length） was located at the seventh intercostal space on the axillary midline, while the utility port （ 3 - 4 cm in len g th ） was located at the fourth inte rcosta l space on the ante rior axillary line. Postoperatively, 1 or 2 chest tubes were placed. Results There was no pe ri-ope rat ive death in the cohort of pa tien ts. No conversion to open thoracotomy was required. No serious postoperative complications occurred. The operation time was （ 139. 2 ± 43. 1） min, the intraoperative blood loss was 30 - 200 ml （ median,55 ml）,the number of lymph node dissected was 16. 9 ± 5. 2,and the postoperative hospital stay was （7. 7 ± 4. 1 ） d. Atelectasis occurred in 4 cas es , and the lung re cru itment was obtained within 1 week by breath training. One case sustained a small amount of leakage, which was cured by the addition of negative pressure suction for 7 days. A total of 116 patients were followed up for 2 -1 3 months （me a n , 6. 8 ± 3. 4 m o n th s ） . No metastat ic carcinoma or re cu rren ce was observed in 115 patients. One patient died from arrhythmia 11 months after operation. Conclusion Single utility port complete VATS is a safe and feasible method in the treatment of lung cancer.

关 键 词：单操作孔 胸腔镜手术 肺叶切除术 肺癌 

分 类 号：R734.2[医药卫生—肿瘤]