鲁米尔联合哈巴狗钳肺动脉阻断在单孔胸腔镜左肺上叶切除中的应用  

Control the pulmonary artery with rumel and bulldog clamp during uniportal thoracoscopic left upper lobectomy

作　　者：詹必成 刘建[1] 陈剑[1] Zhan Bicheng;Liu Jian;Chen Jian(Department of Cardiothoracic Surgery,Anqing Municipal Hospital,Anqing 246003,China)

机构地区：[1]安徽医科大学附属安庆医学中心,安庆市立医院心胸外科,安庆246003

出　　处：《中华胸心血管外科杂志》2024年第1期20-23,共4页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：安徽医科大学校科学研究基金资助项目(2020xkj240)。

摘　　要：目的探讨采用鲁米尔联合哈巴狗钳阻断肺动脉完成单孔胸腔镜左肺上叶切除术的可行性。方法回顾性分析21例患者临床资料,左肺动脉被肿瘤或淋巴结累及,采用鲁米尔阻断左肺动脉干近端,哈巴狗钳阻断左肺动脉中间干,在单孔胸腔镜下完成左肺上叶切除术及肺动脉成形术。结果21例患者均顺利完成手术,2例行支气管成形术,1例同期行胸腺瘤切除,1例同期行左下肺S6a亚段切除。所有患者行肺动脉成形,18例直接连续缝合,2例肺动脉缺损过大,小切口辅助下行自体心包补片修补,1例小切口辅助下支气管肺动脉双袖式切除。手术历时(213.3±40.5)min,肺动脉阻断(16.5±4.6)min。术中出血(152.9±99.9)ml。术后留置胸腔引流管(5.3±2.8)天,术后住院(9.1±3.6)天。围术期无严重并发症。结论鲁米尔联合哈巴狗钳肺动脉阻断技术控制肺动脉可靠,占有空间小,有助于单孔胸腔镜下完成左肺上叶切除及肺动脉成形术。Objective To discuss the feasibility of control the pulmonary artery(PA)with rumel and bulldog clamp during uniportal thoracoscopic left upper lobectomy.Methods Retrospective analysis of clinical data of 21 patients whose left PA infiltrated by tumor or lymph nodes.The Rumel was used to proximal control of the left PA,and the endoscopic bulldog clamp to distal control.The left upper lobectomy and PA reconstruction were completed under single-port thoracoscopy.Results All patients were successfully operated,one patient underwent thymectomy,and one patient underwent left S6a subsegmentectomy at the same time.PA reconstruction was performed by running suture under single-port thoracoscopy in 18 patients,by pericardial patch in 2 patients assisted by small incision,and by circumferential resection in one patient associated with left upper sleeve lobectomy assisted by small incision.The operation time was(213.3±40.5)min,the PA control time was(16.5±4.6)min.The blood loss was(152.9±99.9)ml.Postoperative indwelling time of thoracic drainage tube was(5.3±2.8)days,and the postoperative hospitalization time was(9.1±3.6)days.There were no serious complications during the perioperative period.Conclusion The PA control technique using rumel and bulldog clamp is reliable and occupies less space,which is helpful for the left upper lobectomy and PA reconstruction under uniportal thoracoscopy.

关 键 词：鲁米尔 哈巴狗钳 肺动脉 单孔胸腔镜 肺叶切除术 

分 类 号：R655.3[医药卫生—外科学]