【作者】 张双林； 韦海涛； 王作培； 施巩宁； 闫冰； 马红冰； 马明德；

【Author】 ZHANG Shuang - lin, WEI Hai - tao, WANG Zuo - pei,SHI Gong-ning, YAN Bing, MA Hong-bing, MA Ming - de(Department of Thoracic and cardiovascular Surgery, Huaihe Hospital,Henan University, Kaifeng, Henan 475000, P. R. China)

【机构】 河南大学淮河医院心胸外科；

【摘要】 目的探讨电视胸腔镜手术(VATS)治疗胸心外科疾病的临床经验。方法总结电视胸腔镜或辅助小切口(VAMT)手术368例,包括肺大疱切除、肺楔形或肺叶切除、肺减容术、食管切除、血胸和脓胸清除、食管平滑肌瘤切除、纵隔肿瘤切除、动脉导管结扎及心包开窗手术等。结果全组手术无死亡。围术期并发症17例,占4.6%,均治愈。中转开胸20例,占5.4%,随访5个月～7 a,良性病变术后恢复良好、无复发。食管癌术后3年生存率为58.9%,I期,Ⅱ期和Ⅲa期肺癌术后3年生存率分别为92.2%、51.1%和34.5%。结论VATS是胸心外科领域新的微创手术方法,只要注意预防和减少并发症的发生,VATS治疗胸部疾病是安全可行的。更多还原

【Abstract】 [Objective] To inverstigte the feasibility of video - assisted thoracoscopic surgery (VATS) in thoracic diseases. [Methods] 368 patients were treated with video -assisted thoracoscopic surgery or video -assisted minithoracotomy surgery (VAMT) including bullectomy, lobectomy or wedge resection of lung, mediastinum tumor resection, clearance of hemathorax and empema, esophageal operation, partial pericardial excision and interruption of PDA, et al. [Results] There was no operative mortality. Complications occurred in 17(4.6%). All patients were perfectly recovered by treatment. Twenty patients required conversion to thoractomy(5.4%). The overall follow - up was from 5 months to 7 years. The 3 - year survival rates were 92.2% , 51.1 % and 34.5% for stage I,Ⅱ and Ⅲ a lung cancer. The 3 -year survial rates were 58.9% for esophageal cancer. [Conclusion] VATS is a minimally invasive, safe, effective and new technique of thoracic surgery. More attentions must be payed to prevent and reduce complication in order to generalize the use of it.更多还原