全胸腔镜下解剖性肺段切除术在肺磨玻璃样结节中的应用  

Application of complete video-assisted thoracoscopic anatomic segmentectomy for diagnosis and treatment ofpulmonary ground-glass opacity

作　　者：吴映霖 刘晓明[1] WU Yinglin;LIU Xiaoming(Department of Cardiothoracic Surgery,the First Affiliated Hospital of Nanchang University,Nanchang,Jiangxi 330006,China)

机构地区：[1]南昌大学一附院心胸外科,南昌330006

出　　处：《重庆医学》2019年第A01期40-42,共3页Chongqing medicine

基　　金：江西省教育厅科技支撑计划(60139)。

摘　　要：目的探讨全胸腔镜下(VATS)解剖性肺段切除术治疗肺部磨玻璃样结节(GGO)的可行性及临床应用价值。方法收集自2015年2月至2018年3月该院42例GGO患者经全胸腔镜肺段切除术治疗的临床资料。病例中左肺上叶固有段3例、尖后段5例、舌段8例、前段1例,左肺下叶基底段5例、背段2例;右肺上叶后段、前段、尖段各2例,右肺下叶基底段6例、背段6例。术中所有标本均快速送冰冻检查,如果为良性结节则结束手术,无需清扫淋巴结;恶性肿瘤患者则清扫淋巴结5~7(5.8±0.8)组。结果全组手术均顺利,没有中转开胸。术中出血量50~220(68.2±11.6)mL、手术时间92~215(150±40)min、清扫淋巴结5~16(12.7±0.6)枚,胸腔闭式引流的时间2~6(3.6±0.6)d,没有手术死亡及严重并发症发生,术后患者均痊愈出院,术后随访4~18个月内无肿瘤复发、转移。结论全胸腔镜下解剖性肺段切除术治疗肺部磨玻璃样结节是有效、安全、可行的,突显了微创,具有良好的临床价值。Objective To evaluate the clinicalfeasibility and application of complete video-assisted thoracoscopic surgery(VATS) anatomic segmentectomy for diagnosis and treatment of ground glass opacity. Methods The clinical data of 42 ground-glass opacity cases between February 2015 and March 2018 underwent VATS anatomic segmentectomy were retrospectively analyzed.The locations of resected segments included 3 trisegments、5 apical segments、8 lingular segments、1 anterior segments,5 basement segments and 2 superior segments in the left side;and 2 apical segments 、2 posterior segments 、2 anterior segment,6 basement segments and 6 superior segments in the right side.During operation the fast pathologic examination was carried out to diagnose specimens. Results All of the 42 patients received complete VATS anatomic segmentectomy successfully.The operation time was 92-215(150±40)min,and intraoperative blood loss was 50-220 (68.2± 11.6 )mL,Patients with lung cancer received 5- 7(5.8±0.8) stations of lymph node dissection and the number of lymph node dissection was 5-16(12.7±0.6) for each patient.There was no in-hospital death or postoperative complication.Postoperative thoracic drainage time was 2-6(3.6±0.6)days.All the patients were discharge successfully.Lung cancer patients were followed up for 4-18 months without recurrence or metastasis. Conclusion Complete VATS anatomic segmentectomy is a safe and feasible surgical procedure for diagnosis and treatment of ground-glass opacity.

关 键 词：全胸腔镜手术 GGO 解剖性肺段切除术 

分 类 号：R655.3[医药卫生—外科学]