单向式胸腔镜基底段切除术352例的单中心回顾性研究  

Single-direction video-assisted thoracoscopic surgery anatomic basal segmentectomy in 352 patients:A retrospective study in a single center

作　　者：刘成武[1] 蒲强[1] 梅建东[1] 朱云柯[1] 马林[1] 郭成林[1] 刘伦旭[1] LIU Chengwu;PU Qiang;MEI Jiandong;ZHU Yunke;MA Lin;GUO Chenglin;LIU Lunxu(Department of Thoracic Surgery,West China Hospital,Sichuan University,Chengdu,610041,P.R.China)

机构地区：[1]四川大学华西医院胸外科,成都610041

出　　处：《中国胸心血管外科临床杂志》2022年第10期1284-1289,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：四川大学华西医院学科卓越发展1·3·5工程项目(ZYJC18009;ZYGD18021)。

摘　　要：目的 分享单向式胸腔镜解剖性基底段切除术的临床应用经验。方法 回顾性分析2015年4月—2021年4月于四川大学华西医院行胸腔镜基底段切除术352例患者的临床资料,其中男96例、女256例,中位年龄50(26~81)岁。全组患者均通过胸腔镜手术,经叶间裂或肺下韧带入路,采用单向式思路结合“干-支法”完成各基底段解剖性切除。结果 全组患者均顺利完成手术,其中单孔手术49例、两孔手术3例、三孔手术300例,无增加切口或中转开胸者,无中转为肺叶切除者。中位手术时间118(45~340)min,中位术中出血量20(5~500)mL,中位术后引流时间2(1~22)d,中位术后住院时间4(2~24)d。术后并发症包括肺部感染6例、术后漏气时间>5 d或胸腔引流时间>7 d 18例、脑梗死1例、其它2例,所有患者均经治疗后好转出院。全组无住院期间死亡。结论 胸腔镜下采用单向式方法完成解剖性基底段切除术思路清晰,安全可行。Objective To share the clinical experience of video-assisted thoracoscopic surgery(VATS) anatomic basal segmentectomy by single-direction method. Methods The clinical data of 352 patients who underwent VATS anatomic basal segmentectomy in West China Hospital between April 2015 and April 2021 were retrospectively reviewed,including 96 males and 256 females with a median age of 50(range, 26-81) years. All basal segmentectomies were performed under thoracoscopy, through the interlobar fissure or inferior pulmonary ligament approach, and following the strategy of single-direction and the method of "stem-branch". Results All patients underwent basal segmentectomy successfully(49 patients of uniportal procedure, 3 patients of biportal procedure and 300 patients of triportal procedure)without addition of incisions or conversion to thoracotomy and lobectomy. The median operation time was 118(range,45-340) min, median intraoperative blood loss was 20(range, 5-500) mL, median drainage time was 2(range, 1-22) d and median postoperative hospital stay was 4(range, 2-24) d. The postoperative complications included pneumonia in 6patients, prolonged drainage(air leakage duration>5 d or drainage duration>7 d) in 18 patients, cerebral infarction in 1patient and other complications in 2 patients. All patients were treated well and discharged without main complaints. No perioperative death happened. Conclusion VATS anatomic basal segmentectomy is feasible and safe. It can be performed in a simple manner following the strategy of single-direction.

关 键 词：电视胸腔镜手术 肺段切除 肺癌 单向式 

分 类 号：R734.2[医药卫生—肿瘤]