【摘要】 目的总结单操作孔全胸腔镜肺叶切除术(VATS)的初步经验。方法 2009年12月至2015年5月间江苏省肿瘤医院共进行单操作孔全胸腔镜下肺叶(肺段)切除术71例[其中男性33例,女性38例;年龄38~72岁,平均(55.5±6.9)岁],其中1例左上肺叶袖状切除术,2例肺段切除术。结果单操作胸腔镜肺叶切除术手术时间108~320 min,平均(162.9±56.8)min;操作孔长度2.5~6.0 cm,平均(3.2±0.8)cm;每例患者淋巴结清扫枚数目8~21枚,平均(13.4±4.6)枚;其中2例术中出血,中转开胸,其余均手术顺利。胸腔闭式引流时间术后3~19 d,平均(3.8±3.1)d;住院时间7~35 d,平均(9.8±5.6)d;无围手术期死亡及重大并发症发生。结论单操作孔VATS肺叶切除术安全、可靠,是创伤更小的胸腔镜下手术方式,具有很好的临床推广前景。更多还原

【Abstract】 Objectives This study summed up an initial experience of a single utility video-assisted thoracoscopic surgery( VATS) lobectomy. Methods A total of 71 [male 33,female 38; mean age( 55. 5 ± 6. 9) years old,range 38-72],who underwent major pulmonary resection( segmentectomy,lobectomy,sleeve lobectomy) through a consecutive VATS using a single utility from Dec. 2009 to May2015,were included in this study. Lobectomy was performed in most patients( n = 38),and sleeve lobectomy was performed in 1 patient,and segmentectomy in 2 patients. Results The mean time of the operation,in 71 patients who were completed by two-incisions VATS lobectomy, was [( 162. 9 ±56. 8) minutes( range,108-320) minutes]. The utility incision length was [( 3. 2 ± 0. 8) cm( range,2. 5-6. 0) cm]. The total number of dissected lymph nodes per patient was [( 13. 4 ± 4. 6) range,8-21 range]. Conversion to thoracotomy was performed in 2 patients( 2. 8%) due to bleeding at pulmonary arterial branch. The chest tube was removed on postoperative day [( 3. 8 ± 3. 1) range,3-19 range],and the mean time of hospitalization was [( 9. 8 ± 5. 6) days,range 7-35 days]. There was no occurrence of major perioperative morbidity and mortality. Conclusion In the hands of experienced VATS surgeons,it is safe and feasible to perform VATS lobectomy with a single utility.更多还原