单孔胸腔镜左肺上叶尖后段切除术  

Single-port thoracoscopic resection of the left upper lobe apicoposterior segment

作　　者：韩飞 徐涛 王超 宋琦 何开明 胡智 魏伟 戴天阳 HAN Fei;XU Tao;WANG Chao;SONG Qi;HE Kaiming;HU Zhi;WEI Wei;DAI Tianyang(Department of Thoracic Surgery,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,China;Department of Thoracic Surgery,the Third People's Hospital of Luzhou,Luzhou 646000,China)

机构地区：[1]西南医科大学附属医院胸外科,泸州646000 [2]泸州市第三人民医院胸外科,泸州646000

出　　处：《西南医科大学学报》2022年第2期108-111,共4页Journal of Southwest Medical University

基　　金：四川省教育厅课题(2018013);西南医科大学青年基金(2017-ZRQN-138)。

摘　　要：目的探讨单孔胸腔镜左肺上叶尖后段切除术的流程与安全性。方法回顾分析2020年1月至2021年6月就诊于西南医科大学附属医院胸外科且行单孔胸腔镜左肺上叶尖后段切除术的患者资料,共23例,其中男8例,女15例,中位年龄53岁(34~67岁),所有患者均经左侧腋中线第5肋间切口,由叶间裂入路完成解剖性左肺上叶尖后段切除术。结果叶间裂发育全13例,发育不全10例,均在单孔胸腔镜下完成手术,无中转多孔或开胸病例,中位手术时间100 min(85~120 min),中位术中出血量30mL(10~50mL),中位所需直线切割闭合器订舱5个(5~6个),中位术后带管时间3 d(2~5 d),中位术后住院时间3d(2~7 d),中位淋巴结切除5枚(3~6枚),术后并发症2例,无相关死亡病例。结论无论叶间裂发育全或不全,单孔胸腔镜下左肺上叶尖后段切除均是安全可行的,具有临床推广应用价值。Objective To investigate the procedure of left upper lobe apicoposterior segment resection by single-port thoracoscopy.Methods The clinical data of 23 patients who underwent single-port thoracoscopic resection of the left upper lobe apicoposterior segment in the Department of Thoracic Surgery,the Affiliated Hospital of Southwest Medical University,from January 2020 to June2021 were retrospectively reviewed.There were 8 males and 15 females,with a median age of 53(34~67)years.All patients underwent anatomic left upper lobe apicoposterior segment resection through the interlobar fissure approach via the incision in the 5th intercostal space at the left midaxillary line.Results Thirteen patients with complete interlobar fissure and 10 patients with incomplete interlobar fissure underwent the surgery under the single-port thoracoscope,without conversion to multi-port thoracoscopy or thoracotomy.There were a median operative time of 100 min(85~120 min),a median intraoperative blood loss of 30 mL(10~50 m L),a median number of required linear cutter stapler places of 5(5~6),a median postoperative catheterization time of 3 days(2~5 days),a median postoperative hospital stay of 3 days(2~7 days),and a median number of resected lymph nodes of 5(3~6).There were 2 patients with postoperative complications and no surgery-related death.Conclusion Single-port thoracoscopic resection of the left upper lobe apicoposterior segment is safe and feasible,regardless of complete or incomplete interlobar fissure.

关 键 词：单孔胸腔镜 左肺上叶尖后段 肺段切除 安全性 

分 类 号：R655.3[医药卫生—外科学]