全胸腔镜下全肺切除术10例近期结果  

Thoracoscopic Pneumonectomy: Short-term Outcome of 10 Cases

作　　者：江贤亮[1] 徐美青[1] 徐世斌[1] Jiang Xianliang;Xu Meiqing;Xu Shibin(Department of Thoracic Surgery,Anhui Provincial Hospital,Hefei 230001,China)

机构地区：[1]安徽省立医院胸外科,合肥230001

出　　处：《中国微创外科杂志》2019年第1期19-21,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨全胸腔镜下全肺切除术的近期效果。方法回顾性分析我院2015年9月～2017年12月全胸腔镜下全肺切除术10例资料。跨叶间裂生长中央型肺癌9例,支气管扩张伴右侧毁损肺1例。均因肺叶切除无法根治切除,故行全肺切除。采用两孔法或三孔法胸腔镜切口,使用腔镜下直线切割缝合器依次切断肺静脉-肺动脉-支气管,完整切除一侧全肺。结果 10例手术均顺利完成,无围术期死亡。手术时间(246±52) min,术中出血量(110±42) ml,淋巴结清扫(8. 4±2. 7)枚,术后住院时间(11. 2±3. 8) d,术后并发症3例(心房纤颤2例,乳糜胸1例)。术后随访1～26个月,中位时间9个月。死亡1例,肿瘤转移带瘤生存1例,无病生存8例。结论全胸腔镜下全肺切除术安全可行,近期效果尚可,远期效果有待进一步观察。Objective To evaluate the short-term clinical value of thoracoscopic pneumonectomy. Methods We retrospectively analyzed the clinical data of 10 patients who underwent thoracoscopic pneumonectomy for pulmonary diseases from September 2015 to December 2017 in our hospital.There were 9 cases of lung cancer with interlobular fissure invasiveness,and 1 case of bronchiectasis with right destroyed lung.Pneumonectomy was performed because lobectomy could not be radical.Unilateral total lung resection was taken via two or three ports.We cut off the lung with vein-artery-bronchus in order by using a linear stapler.Results All the 10 cases received operations successfully and no operative morality occurred.The operation time was (246±52) min,the intraoperative blood loss was (110±42) ml,the number of lymph node resected was (8.4±2.7) nodes,and the postoperative hospital stay was (11.2±3.8) d.Postoperative complications occurred in 3 cases,including 2 cases of atrial fibrillations and 1 case of chylothorax.All the complications were relieved after conservative medical therapy.The follow-up was taken for 1-26 months (median,9 months).There were 1 fatal case,1 case survived with tumor recurrence,and 8 cases of disease-free survival.Conclusions Thoracoscopic pneumonectomy is safe and feasible.The long-term outcomes need further observation.

关 键 词：胸腔镜 全肺切除 肺癌 

分 类 号：R734.2[医药卫生—肿瘤]