Nakamura H, Taniguchi Y, Makihara K, Metsugi H, Maeta H, Ishiguro K, Ohgi S
Second Department of Surgery, Tottori University, Faculty of Medicine, Yonago, Japan.
Kyobu Geka. 2000 Jan;53(1):34-8.
Effectiveness and present problems of video-assisted thoracic surgery (VATS) for metastatic lung tumor were investigated by comparing 14 cases (16 operations) of VATS with 16 cases (19 operations) of conventional thoracotomy during the same period. VATS was favorably selected in the solitary metastasis. The cases who had small tumor diameter less than 3 cm and shorter distance from viseral pluera to the tumor surface than tumor diameter were advantageous for only thoracoscopic procedure to do the safe and sure resection. Regarding to the tumor number, we detected another tumor intraoperatively in 2 of 16 cases (12.5%) of VATS and 6 of 19 cases (31.6%) of thoracotomy. Multiple metastases had the tendency to have the differences of the tumor number between preoperation and intraoperation. Prognosis is very good until now, but the recurrence rate was high (64.5%) and one case had the recurrence at the surgical margin. VATS for metastatic tumor is very effective, but it is important not to hesitate to do the mini-thoracotomy and convert to conventional thoracotomy for safe and sure resection.
通过同期比较14例（16次手术）电视辅助胸腔镜手术（VATS）和16例（19次手术）传统开胸手术，研究了VATS治疗转移性肺肿瘤的有效性及存在的问题。VATS适用于孤立性转移。肿瘤直径小于3 cm且脏层胸膜至肿瘤表面的距离短于肿瘤直径的病例仅采用胸腔镜手术即可安全、确切地切除肿瘤。关于肿瘤数量，我们在16例VATS病例中的2例（12.5%）和19例开胸手术病例中的6例（31.6%）术中发现了其他肿瘤。多发转移在术前和术中的肿瘤数量上往往存在差异。目前预后良好，但复发率较高（64.5%），有1例在手术切缘复发。VATS治疗转移性肿瘤非常有效，但为了安全、确切地切除肿瘤，毫不犹豫地进行小切口开胸并转为传统开胸手术很重要。
