“静脉流域分析法”切除位于亚段交界位置的早期周围型肺癌10例报告  

Anatomical Partial Lobectomy Based on“Venous Watershed Analysis”for Early-stage Peripheral Lung Cancer Located Between the Adjacent Subsegments:a Clinical Analysis of 10 Cases

作　　者：张楠 陈树兴 许德新 许添辉 林宇斌 陈星 Zhang Nan;Chen Shuxing;Xu Dexin(Department of Thoracic Surgery,Fuzhou Pulmonary Hospital of Fujian Province,Fuzhou 350000,China)

机构地区：[1]福建省福州肺科医院胸外科,福州350000

出　　处：《中国微创外科杂志》2023年第7期543-546,共4页Chinese Journal of Minimally Invasive Surgery

基　　金：福建省青年基金项目(2021QNA066);福州市重点专科项目(201912003)。

摘　　要：目的探讨“静脉流域分析法”精准切除位于亚段交界位置的早期周围型肺癌的可行性。方法2021年9月~2022年10月我科采用“静脉流域分析法”精准切除10例位于亚段交界位置的早期周围型肺癌。术前行三维重建,确定结节位于肺亚段交界,明确结节归属静脉流域及其靶静脉,行单操作孔胸腔镜手术,术中暂时阻断靶静脉,无需处理动脉、支气管,荧光反染法或膨胀-萎陷法确定边界,然后释放阻断的靶静脉,根据边界切除靶肺。结果10例均顺利完成手术,无扩大切除,无中转肺叶切除。手术时间52~100 min,平均74 min;术中出血量10~50 ml,平均20 ml。术后引流时间1~4 d,平均2.6 d。术后住院时间3~6 d,平均4.4 d。切除淋巴结1~5枚,(3.1±1.2)枚,均未见肿瘤转移。10例随访2~15个月,平均10.1月,无并发症,无死亡。结论“静脉流域分析法”精准切除位于亚段交界位置的早期周围型肺癌安全、可行。Objective To investigate the feasibility of anatomical partial lobectomy based on“venous watershed analysis”for early-stage peripheral lung cancer located between the adjacent subsegments.Methods Clinical data of 10 patients with early-stage peripheral lung cancer located between the adjacent subsegments who underwent the anatomical partial lobectomy based on“venous watershed analysis”between September 2021 and October 2022 were retrospectively reviewed.Before the operation,three-dimensional reconstruction was performed to confirm that the nodule was located between the adjacent subsegments and its venous drainage basin and target vein.The single utility port thoracoscopic surgery was performed.During the operation,the target vein was temporarily blocked without the need to deal with the arteries and bronchi.The boundary was determined by using the indocyanine green fluorescence reverse staining or inflation-deflation method.Then the blocked target vein was released,and the target lung was removed according to the boundary.Results All the patients underwent segmentectomy successfully without conversion to multi-portal procedure or thoracotomy.The operation time was 52-100 min(mean,74 min),the intraoperative bleeding volume was 10-50 ml(mean,20 ml),the postoperative drainage time was 1-4 d(mean,2.6 d),and the postoperative hospitalization time was 3-6 d(mean,4.4 d).The number of lymph nodes removed was 1-5(mean,3.1±1.2),which showed no tumor metastasis.All the 10 patients were followed up for 2-15 months,with an average of 10.1 months.There were no complications or deaths.Conclusion The anatomical partial lobectomy based on“venous watershed analysis”in the treatment of early-stage peripheral lung cancer located between the adjacent subsegments is safe and feasible.

关 键 词：静脉流域分析 解剖性部分肺切除术 周围型肺癌 

分 类 号：R734.2[医药卫生—肿瘤]