单孔胸腔镜后入路解剖性右上肺叶切除术  

Posterior Approach Uniportal Video-assisted Thoracoscopic Surgery of Anatomic Right Upper Lobectomy

作　　者：颜建华[1] 向泓宪 张志功[1] 刘慧[1] 田双如 周文武[1] 杨劲松[1] 周亚夫[1] Yan Jianhua;Xiang Hongxian;Zhang Zhigong(Department of Cardiothoracic Surgery, Hunan Provincial People’s Hospital, First Affiliated Hospital of Hunan Normal University, Changsha 410005, China)

机构地区：[1]湖南省人民医院,湖南师范大学附属第一医院心胸外科,长沙410005

出　　处：《中国微创外科杂志》2020年第8期696-699,共4页Chinese Journal of Minimally Invasive Surgery

基　　金：湖南省科技厅临床医疗技术创新引导项目(2018SK50707)。

摘　　要：目的探讨单孔胸腔镜后入路解剖性右上肺叶切除术的安全性及可行性。方法回顾性分析2018年10月~2019年12月66例非小细胞肺癌(non-small cell lung cancer,NSCLC)行单孔胸腔镜后入路解剖性右上肺叶切除+系统性纵隔淋巴结清扫术的围术期资料。记录手术时间、术中失血量、淋巴结切除数目、并发症、胸管引流时间、术后住院时间、术后疼痛视觉模拟评分(Visual Analogue Scale,VAS)。结果手术均顺利完成,无术中及术后30天死亡,无中转传统三孔胸腔镜或开胸手术。手术时间85~225(138.1±32.2)min,失血量10~500(中位数50)ml,清扫淋巴结3~35(18.5±6.5)枚,并发症发生率16.7%(11/66),胸管留置时间1~11(中位数2)d,术后住院时间3~12(5.7±1.7)d。术后第1、3、7、30天VAS分别为2.9±0.9、2.7±0.9、1.2±0.6、0.3±0.5。结论单孔胸腔镜后入路解剖性右上肺叶切除术安全、可行。Objective To explore the safety and feasibility of posterior approach uniportal video-assisted thoracoscopic surgery for anatomic right upper lobectomy.Methods The perioperative clinical data of 66 patients with non-small cell lung cancer(NSCLC)who underwent uniportal video-assisted thoracoscopic surgery of anatomic right upper lobectomy via posterior approach from October 2018 to December 2019 were retrospectively analyzed.The operative time,intraoperative blood loss,number of lymph nodes removed,complications,chest tube duration,postoperative length of hospital stay,and Visual Analogue Scale(VAS)score were recorded.Results All the 66 patients were successfully underwent posterior approach uniportal video-assisted thoracoscopic surgery of anatomic right upper lobectomy and systemic mediastinal lymph node dissection.There were no operative or 30-day mortality,and no conversion to traditional 3-port thoracoscopic surgery or thoracotomy.The operation time was 85-225 min(mean,138.1±32.2 min),and the blood loss was 10-500 ml(median,50 ml).The number of lymph nodes dissected was 3-35(mean,18.5±6.5),the complications rate was 16.7%(11/66),the time of chest tube drainage was 1-11 d(median,2 d),and the postoperative length of hospital stay was 3-12 d(mean,5.7±1.7 d).The VAS scores on postoperative day 1,day 3,day 7 and day 30 were 2.9±0.9,2.7±0.9,1.2±0.6,and 0.3±0.5,respectively.Conclusion Posterior approach uniportal video-assisted thoracoscopic surgery of anatomic right upper lobectomy is safe and feasible.

关 键 词：单孔胸腔镜手术 肺癌 后入路 解剖性右上肺叶切除术 

分 类 号：R73[医药卫生—肿瘤]