单孔近红外荧光胸腔镜肺段切除术的临床应用及优势研究  

Clinical application and advantages of near-infrared fluorescence guided uni-port thoracoscopic segmentectomy

作　　者：刘政呈[1] 杨如松[1] 曹珲[1] 邵丰[1] LIU Zhengcheng;YANG Rusong;CAO Hui;SHAO Feng(Department of Thoracic Surgery,Nanjing Chest Hospital,Nanjing,Jiangsu 210029,China)

机构地区：[1]江苏省南京市胸科医院胸外科

出　　处：《重庆医学》2019年第18期3099-3103,共5页Chongqing medicine

基　　金：江苏省青年医学人才项目(QNRC2016124);江苏省南京市医学科技计划项目(YKK16205)

摘　　要：目的分析单孔近红外荧光胸腔镜肺段切除术的安全性、可行性及优势。方法回顾性分析2018年1-12月该院完成的单孔近红外荧光胸腔镜肺段切除术185例患者(试验组),以及2016年6月至2017年12月完成单孔胸腔镜肺段切除术227例(对照组)。所有患者采用单孔胸腔镜手术,妥善离断靶段血管、支气管后,试验组使用吲哚菁绿反染法确定段间面,对照组则使用改良膨胀-萎陷法。结合能量设备及直线切割闭合器进行适形裁剪,实现段间交界的分离。根据术中快速病理结果指导淋巴结采样方式。结果两组患者临床一般资料、病灶性状、所属肺叶、术后病理等比较,差异无统计学意义(P>0.05)。手术均顺利完成,试验组的平均手术时间[105(65,165)min]明显短于对照组[130(85,205)min],两组患者术后均顺利康复。结论单孔近红外荧光胸腔镜可快速、精准地实现肺段切除术。Objective To investigate the safety,feasibility and advantages of near-infrared fluorescence guided uni-portal thoracoscopic segmentectomy. Methods A retrospective analysis was performed on 185 cases of near-infrared fluorescence guided uni-port thoracoscopic segmentectomy completed in this hospital from January 2018 to December 2018 (the experimental group) and 227 cases underwent single-port thoracoscopic segmentectomy from June 2016 to December 2017 (the control group).All patients underwent uni-portal thoracoscopic surgery.After proper dissection of the target vessels and bronchus,the experimental group was determined the intersegmental plane using indocyanine green reverse staining method,while the control group using modified dilation and collapse method.Conformal cutting was carried out using energy equipment and endoscopic stapler to separate intersegment plane.Lymph node sampling was guided by intraoperative rapid pathological results. Results There were no statistically significant differences between the two groups in clinical general data,lesion characteristics,position in each pulmonary lobe,and postoperative pathology (P >0.05).All operations were completed successfully.The average operation time of the experimental group [105(65,165)min] was significantly shorter than that of the control group [130(85,205)min].All patients recovered well after surgery in both groups. Conclusion Uni-portal near-infrared fluorescence thoracoscopy can achieve fast and precise segmentectomy.

关 键 词：近红外荧光 单孔胸腔镜 肺段切除术 成像 三维 

分 类 号：R655.3[医药卫生—外科学]