单操作孔胸腔镜下支气管袖式切除术3例分析  

Analysis of three cases of single hole thoracoscopic bronchial sleeve resection

作　　者：刘永志[1] 陈剑[1] 刘建[1] 陈大庆 王啸[1] LIU Yongzhi;CHEN Jian;LIU Jian;CHEN Daqing;WANG Xiao(Department of Cardiothoracic Surgery,Anqing Hospital,Anhui Medical University,Anqing,Anhui 246003,China)

机构地区：[1]安徽医科大学附属安庆医院心胸外科,安徽安庆246003

出　　处：《安徽医药》2020年第4期775-779,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的总结胸腔镜支气管袖式切除术的临床经验。方法回顾性分析安徽医科大学附属安庆医院心胸外科2016年7—12月开展3例单操作孔胸腔镜支气管袖式切除术治疗中央型肺癌手术结果以及术后跟踪随访20~26个月情况。结果3例均在单操作孔全胸腔镜下顺利完成,手术时间265~315 min,平均281.67 min,支气管吻合时间23~41 min,平均31.33 min;清扫淋巴结7~15枚,平均11.33枚;术后复查胸部CT余肺复张良好,支气管吻合口通畅,均未出现肺不张、支气管吻合口瘘、声嘶、呛咳等并发症,均顺利出院,术后住院时间10~13 d,平均11.33 d;术后病理2例为鳞状细胞癌,1例未分类癌,病理分期分别是pT2N0M0、pT1cN1M0、pT3N0M0。术后半年内均行4次正规化疗,随访20~26个月,随访率100%,胸部CT检查未见明显转移及复发,支气管通畅未见明显狭窄,随访期间无声嘶、呛咳等并发症。结论单操作孔胸腔镜下支气管袖式切除术治疗中央型肺癌是安全、有效、可行的。Objective To summarize the clinical experience of thoracoscopic bronchial sleeve resection.Methods Retrospective analysis was performed on the surgical results of 3 cases of central lung cancer treated with single operation thoracoscope broncho sleeve resection in Department of Cardiothoracic Surgery,Anqing Hospital,Anhui Medical University from July 2016 to December 2016,as well as the follow up of 20 to 26 months postoperatively.Results All of the 3 cases were successfully completed under thoracoscopic surgery with single operation hole.The operation time was 265~315 min,with an average of 281.67 min,and the bronchial anastomosis time was 23~41 min,with an average of 31.33 min.7~15 lymph nodes were dissected,with an average of 11.33.Postoperative chest CT reexamination showed good recovery of residual lung,and bronchial anastomosis was unobstructed.No complications,such as atelectasis,bronchial anastomotic fistula,hoarseness,and chokehold,were found.The postoperative hospital stay was 10~13 d,with an average of 11.33 d.All patients were discharged successfully.Postoperative pathology included 2 cases of squamous cell carcinoma and 1 case of unclassified carcinoma.The pathological stages were pT1bN0M0,pT1cN1M0 and pT3N0M0,respectively.All patients received 4 times of normal chemotherapy within half a year after surgery,followed up for 20~26 months,with 100% follow up rate.No obvious metastasis or recurrence was found in chest CT examination,no obvious stenosis was found in bronchial patency,and no symptoms such as hiss or cough were observed during follow up.Conclusion Single opera tion thoracoscope bronchosleeve resection for treating central lung cancer is safe,effective and feasible.

关 键 词：肺切除术/方法 胸腔镜检查 肺肿瘤 单操作孔 支气管袖式切除术 

分 类 号：R734.2[医药卫生—肿瘤]