以肺亚段为解剖单位的精准肺外科手术策略的初步报道  

A single-center retrospective analysis of a surgical strategy based on pulmonary sub-segments

作　　者：赵志鹏 马永富[1] 冯长江[1] 张猛[1] 刘阳[1] Zhao Zhipeng;Ma Yongfu;Feng Changjiang;Zhang Meng;Liu Yang(Department of Thoracic Surgery,The First Medical Center,The Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心胸外科,北京100853

出　　处：《中华腔镜外科杂志（电子版）》2023年第2期85-90,共6页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

摘　　要：目的探索以肺亚段为解剖单位规划亚肺叶切除的手术策略围手术期安全性。方法回顾性分析2021年2月至2022年2月期间于解放军总医院第一医学中心胸外科完成的150例患者资料,其中以肺亚段为解剖单位的手术策略执行手术29例、肺段切除术74例、肺叶切除术47例,比较围手术期及随访数据。结果所有组均无围手术期死亡,随访12个月均未见肿瘤复发进展。在切除的肺亚段数量、切除的肺体积、术中清扫的淋巴结区域、清扫的淋巴结数目比较中,肺亚段组与肺段组之间差异无统计学意义,肺亚段组与肺段组均少于肺叶组。肺亚段组的手术时间、术中使用的切割缝合器数量高于肺段组与肺叶组。三组之间的术中出血量、术后置管时间、术后住院时间差异均无统计学意义。主要并发症为肺部漏气,三组之间差异无统计学意义。结论以肺亚段为解剖单位的手术策略执行手术难度较高,在实践中安全可行,可以应用于符合亚肺叶切除术指征的患者。Objective To explore the perioperative safety of a sublobar resection strategy based on using lung subsegments as anatomical units.Methods Review and analyze the clinical data of 150 patients with pulmonary nodules who underwent surgery in the First Medical Center of the PLA General Hospital from Feb.2021 to Feb.2022,including 29 surgeries performed with a surgical strategy using lung subsegments as surgical anatomical units,74 resections with lung segments as units,and 47 lobectomies.Their perioperative and follow-up data were compared.Results There were no perioperative deaths in all groups,and no tumor recurrence progression was seen in any of the groups at 12 months of follow-up.Among the three groups,there was no significant statistical difference in gender,age,body mass index,intraoperative blood loss,postoperative pulmonary leakage or postoperative hospitalization days.There were statistical differences in volume of remoted pulmonary tissue,number of subsegments involved,surgery duration and numbers of stapling devices.Conclusions The surgical strategy of using lung subsegments as anatomical units is difficult,safe and feasible in practice,and can be applied to patients who meet the indications for sublobar resection.

关 键 词：肺结节 肺癌 肺亚段 亚肺叶切除 

分 类 号：R655.3[医药卫生—外科学]