【摘要】 目的探讨电视胸腔镜辅助小切口(video-assisted mini-thoracotomy,VAMT)肺叶切除术在周围型肺癌治疗中的应用价值。方法2004年1月～2007年12月对56例周围型肺癌全麻下施行VAMT肺叶切除术,其中右肺上叶5例,右肺中叶2例,右肺下叶19例,左肺上叶8例,左肺下叶22例。双腔气管插管单肺通气,于第4或第5肋间做长6.0～8.0cm辅助小切口进胸,第6肋间隙腋中线1.5cm切口,置入胸腔镜。切除肺叶从小切口取出。常规清扫区域肿大淋巴结。结果术中未延长切口,纵隔淋巴结清扫平均14枚/例(9～31枚/例)。手术时间120～220min,(145±35)min。术中出血量100～450ml,(210±48)ml。术后住院5～11d,平均7d。7例出现并发症(7/56,12.5%),包括胸腔积液5例,肺膨胀不全2例。56例随访1年,3例死亡,1年生存率94.6%(53/56)。结论VAMT肺叶切除术对周围型肺癌是一种安全可行的手术方法。更多还原

【Abstract】 Objective To assess the value of lobectomy by video-assisted mini-thoracotomy(VAMT) for the treatment of peripheral pulmonary carcinoma.Methods From January 2004 to December 2007,56 cases of peripheral pulmonary carcinoma underwent VAMT lobectomy under general anaesthesia in our hospital.Of the patients,5 had the tumor in the upper lobe of the right lung,2 in the middle lobe of the right lung,19 in the superior lobe of the right lung,8 in the upper lobe of the left lung,and 22 in the superior lobe of the left lung.All the tumors were no more than 5 cm in diameter.All the cases were intubated with double-lumen tubes and then one-lung ventilation was performed.With the patients being placed in a lateral position,a mini-incision(6.0-8.0 cm in length) was made at the fourth or fifth intercostal space.And another 1.5-cm incision was made at the sixth intercostal space along the midaxillary line for introducing the video-thoracoscope.The resected pulmonary lobe was removed though the mini-incision.Afterwards,enlarged lymph nodes were dissected as routine.Results During the operation,no incision was prolonged in the cases.A mean of 14 lymph nodes were removed(ranged from 9 to 31).The mean operation time was(145±35) min(range,120 to 220 min),and the intraoperative hemorrhage was 100 to 450 ml [(210±48) ml].The patients were discharged from hospital in 5 to 11 days(mean,7 days).Seven of the patients developed complications including thoracic effusion in 5 and atelectasis in 2.The patients were followed up for 1 year,3 of them died during the period(1 year survival rate:94.6%).Conclusion VAMT lobectomy is feasible and safe for peripheral lung cancer.更多还原