单操作孔胸腔镜手术1.5 cm操作孔取出标本：小切口,大标本  

Single Utility Port Video-assisted Thoracoscopic Surgery Extracting Specimen From a 1. 5 cm Access Thoracotomy Incision:Small Incision,Large Specimen

作　　者：钱俊 周超[2] 沈宇舟[2] 黄平[2] 李文涛[2] Qian Jun, Zhou Chao, Shen Yuzhou, et al.(Department of Thoracic Surgery, Shanghai Chest Hospital of Shanghai Jiao Tong University, Shanghai 200030, Chin)

机构地区：[1]昆明医科大学附属云南省德宏州人民医院胸外科,芒市678400 [2]上海交通大学附属胸科医院胸外科,上海200030

出　　处：《中国微创外科杂志》2018年第7期661-663,共3页Chinese Journal of Minimally Invasive Surgery

基　　金：上海市胸科医院科技发展基金(2014YZDC20100)

摘　　要：目的探讨一种安全、可行、实用的1.5 cm操作孔标本取出的临床价值。方法 2017年5~6月我们成功实施单操作孔胸腔镜手术87例,全胸腔镜下完成病灶切除(包括肺叶切除、肺段切除、肺楔形切除、纵隔肿瘤切除、活检术及全肺切除),从1.5 cm操作孔取出手术标本。结果 82例(94.3%)使用此法均较为顺利取出手术标本,1例(1.1%)左上肺切除病例延长切口至3.0 cm后取出标本,1例(1.1%)纵隔肿瘤延长切口至3.5 cm后取出标本,3例(3.4%)全肺切除延长切口至4.0 cm后取出标本。术后切口美观,发生切口脂肪液化1例,切口感染1例,切口皮下气肿2例,无其他严重并发症。结论此法术后切口美观,能够取出大部分标本,必要时适当延长切口均能顺利取出手术标本,是一种安全、可行、实用的小切口(1.5 cm)标本取出法。Objective To investigate a safe,feasible and practicable method for specimen extraction technique with a 1. 5 cm access thoracotomy incision. Methods From May to June 2017,we conducted 87 cases of single utility port video-assisted thoracoscopic surgery excision of the lesion（ including lobectomy,segmentectomy,wedge resection,mediastinal tumor resection,biopsy and pneumonectomy）. The specimen was extracted from the 1. 5 cm incision. Results The surgical specimens were smoothly extracted in 82 cases（ 94. 3%）. One patient（ 1. 1%） underwent left upper lung specimen extraction by expanding the incision to 3. 0 cm. One patient（ 1. 1%） with mediastinal tumor underwent expanding the incision to 3. 5 cm. And 3 patients（ 3. 4%） of pneumonectomy were given incision expanding to 4. 0 cm to extract the specimen. After operation,the incisions had good appearance.There were 1 case of fat liquefaction,1 case of incision infection,and 2 cases of subcutaneous emphysema. There were no other serious complications. Conclusions This incision has good appearance,and most of the specimens can be extracted from the insion. The specimens can be extracted by expanding the incision appropriately as necessary. It is a safe,feasible and practicable method for specimen extraction with a 1. 5 cm access thoracotomy incision.

关 键 词：单操作孔 胸腔镜手术 切口长度 切口并发症 

分 类 号：R655[医药卫生—外科学]