【摘要】 目的:探讨全电视胸腔镜(VATS)下肺叶切除治疗肺部疾病的可行性、近期疗效,总结围手术期处理经验。方法:回顾分析我科2009年4月至2009年7月,采用不撑开肋骨、完全在电视胸腔镜下完成肺叶切除10例,其中施行右肺上叶切除5例,右肺中叶1例;左肺上叶2例,左肺下叶2例;恶性肿瘤患者同期行纵隔及肺门淋巴结清扫。结果:全组10例患者中8例在全胸腔镜下顺利完成肺叶切除及淋巴结清扫,手术时间90~220min(平均130min);术中失血量50~450ml(平均245 ml);术后病理诊断为肺癌6例,结核瘤1例,炎性假瘤1例,支气管扩张1例,绒毛膜转移癌1例。无手术死亡。术后住院时间6~12d(平均8.5d)。结论:全胸腔镜下肺叶切除治疗肺部疾病更加微创,且手术安全可行,术后并发症少、恢复快。更多还原

【Abstract】 Objective:To investigate the feasibility,curative effect and peri-operative treatments of lobectomy for pulmonary diseases by complete video—assisted thoracoscopic surgery(VATS).Method:Ten patients with pulmonary diseases were treated with thoracoscopic lobectomy(including mediastinal and hilar lymph node dissection for malignant diseases)from April 2009 to July 2009 in our Department.Five right upper lobectomy,one right middle lobectomy,two left upper lobectomy,two left lower lobectomy were operated.Mediastinal and hilar lymph node dissection was simultaneously performed in the malignant cases.The feasibility,safety and postoperative complications were retrospectively analyzed.Result: Eight patients were performed successfully by complete VATS.The median operative duration and blood loss were respectively 130min(from 90min to 220min)and 245 m1(from 50m1 to 450m1).The postoperative pathology diagnosis was lung cancer in six,tuberculoma in one,inflammatory pseudo-tumor in one,bronchiectasis in one and malignant choriocarcinoma in one.No other severe complications was observed.The average postoperative hospitalization was 8.5 days(from 6 days to 12 days).Conclusion: Lobectomy for pulmonary diseases by complete VATS is technically feasible,safe,minimally invasive with less complications and fast rehabilitation.更多还原