单孔胸腔镜右肺中叶切除术的临床研究  

Clinical study of single-port thoracoscopic right middle lobe resection

作　　者：阚奇伟 刘泗军 闵科 庞金桥 李杰[2] 张勇[3] 黄伟[3] 李垚松 KAN Qi-wei;LIU Si-jun;MIN Ke;PANG Jin-qiao;LI Jie;ZHANG Yong;HUANG Wei;LI Yao-song(Department of Thoracic Surgery,West China Meishan Hospital of Sichuan University,Meishan Sichuan 620010,China;Department of Anesthesiology,West China Meishan Hospital of Sichuan University,Meishan Sichuan 620010,China;Department of Operating Room,West China Meishan Hospital of Sichuan University,Meishan Sichuan 620010,China)

机构地区：[1]四川大学华西眉山医院胸心外科,四川眉山620010 [2]四川大学华西眉山医院麻醉科,四川眉山620010 [3]四川大学华西眉山医院手术室,四川眉山620010

出　　处：《局解手术学杂志》2022年第12期1096-1099,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：陕西省科技攻关项目(2015SF044)。

摘　　要：目的分析单孔胸腔镜右肺中叶切除术的疗效及安全性。方法纳入我院行单孔胸腔镜右肺中叶切除术治疗的患者26例,分析术中情况、术后情况、病理学结果、术后随访资料,并总结手术操作经验。结果中位手术时间为105 min(75~160 min),中位出血量为40 mL(20~90 mL),中位淋巴结切除数为5枚(3~9枚)。中转开胸1例(3.8%),肺动脉变异2例(7.7%),联合其他肺叶楔形切除或肺段切除6例(23.1%)。术后胸腔引流管中位留置时间为3 d(2~6 d),中位引流量为210 mL(110~700 mL),中位住院时间为5 d(4~12 d)。有3例(11.5%)术后漏气超过4 d,有1例(3.8%)出现肺部感染。26例患者中腺癌22例(84.6%),鳞癌1例(3.8%),良性病变3例(11.5%)。术后22例(84.6%)患者获得随访,无死亡病例,术后咳嗽1个月以上者2例(9.1%),术后1个月正常行走自觉心累或呼吸困难者2例(9.1%),均为同时行其他肺叶楔形切除或肺段切除者。结论单孔胸腔镜右肺中叶切除术是安全、有效的,掌握一定的手术技巧可顺利解决术中角度受限的问题。Objective To analyze the efficacy and safety of single-port thoracoscopic right middle lobe resection.Methods A total of 26 patients who underwent single-port thoracoscopic right middle lobe resection in our hospital were included.The intraoperative and postoperative conditions,pathological results and postoperative follow-up data were analyzed,and the operative experience was summarized.Results The median operation time was 105 minutes(75 to 160 minutes),the median amount of blood loss was 40 mL(20 to 90 mL),and the median number of excised lymph nodes was 5(3 to 9).There was 1 case(3.8%)converted to thoracotomy,2 cases(7.7%)with pulmonary artery mutation,and 6 cases(23.1%)underwent combination of other lobe wedge resection or lung segment resection.The median postoperative retention time of thoracic drainage tube was 3 days(2 to 6 days),the median drainage volume was 210 mL(110 to 700 mL),and the median hospital stay was 5 days(4 to 12 days).There were 3 cases(11.5%)of air leakage lasted more than 4 days after operation,and 1 case(3.8%)of lung infection.Among the 26 patients,22 cases(84.6%)were adenocarcinoma,1 case(3.8%)was squamous cell carcinoma,and 3 cases(11.5%)were benign lesions.Twenty-two patients(84.6%)were followed up after operation,and no death occurred.There were 2 cases(9.1%)with cough for more than 1 month after surgery,and 2 cases(9.1%)with tiredness or dyspnea when normally walked 1 month after surgery,all of which were the patients who had undergone other lobe wedge resection or lung segment resection simultaneously.Conclusion Single-port thoracoscopic right middle lobe resection is safe and effective,and mastering certain surgical skills can smoothly solve the problem of intraoperative angle limitation.

关 键 词：单孔胸腔镜手术 右肺中叶 腺癌 鳞癌 良性病变 

分 类 号：R655.3[医药卫生—外科学]