单孔胸腔镜全肺切除治疗非小细胞肺癌:单中心23例经验  

Uniportal video-assisted thorascopic pneumonectomy for 23 patients with non-small cell lung cancer:single-center experience

作　　者：万紫微 黄威[1] 姜格宁[1] Wan Ziwei;Huang Wei;Jiang Gening(Department of Thoracic Surgery,Shanghai Pulmonary Hospital,Tongji University,School of Medicine,Shanghai 200433,China)

机构地区：[1]同济大学附属上海市肺科医院胸外科,200433

出　　处：《中华胸心血管外科杂志》2020年第9期518-521,共4页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的探讨单孔全胸腔镜全肺切除术治疗非小细胞肺癌的安全性和有效性及其手术技巧。方法回顾性分析2017年1月至2018年6月行单孔全胸腔镜下全肺切除术治疗非小细胞肺癌23例;其中男20例,女3例;年龄(60.3±6.0)岁。手术全部通过单孔全胸腔镜完成解剖性全肺切除。统计分析围手术期各项数据。结果全组手术过程顺利,无中转开胸病例。其中单孔胸腔镜左全肺切除17例,右全肺切除6例。手术时间(160.8±65.0)min,术中出血(131.3±121.3)ml,总住院(14.0±6.3)天,术后住院(8.0±4.5)天。术后并发症4例(17.4%),其中肺部感染2例,心律失常1例,术后对侧气胸发作1例,经治疗后均好转,无围手术期死亡。术后病理均证实为肺癌,其中腺癌5例,鳞癌15例,大细胞癌2例,腺癌合并大细胞癌1例。结论选择合适病例且熟练掌握胸腔镜技术,单孔全胸腔镜下全肺切除术安全可行,未增加全肺切除术围手术期风险,有临床应用价值。Objective To evaluate the feasibility and safety of uniportal video-assisted thorascopic pneumonectomy for non-small cell lung cancer patients,as well as the surgical techniques.Methods From January 2017 to June 2018,23 non-small cell lung cancer patients who underwent uniportal VATS pneumonectomy in our hospotal were retrospectively evaluated.There were 20 males and 3 females with a mean age of(60.3±6.0)years.The clinical data,complications and operative mortality were analyzed.Results All 23 patients with lung cancer were operated safely.There was no conversion to thoracotomy.The mean operating time was(160.8±65.0)min.The mean blood loss was(131.3±121.3)ml.The mean hospital stays were(14.0±6.3)days.The mean postoperative hospital stays were(8.0±4.5)days.Postoperative morbidity occurred in 4 patients(17.4%).There was no perioperative mortality.Pathology examination of all patients were lung cancer(5 cases of adenocarcinoma,15 cases of squamous carcinoma,2 cases of large cell carcinom,1 case of adenocarcinoma combined with large cell carcinoma).Conclusion Uniportal video-assisted thorascopic pneumonectomy is a feasible operation that could be performed safely in a selected group of patients by experienced surgeons.

关 键 词：单孔胸腔镜 全肺切除术 肺癌 

分 类 号：R734.2[医药卫生—肿瘤]