Yang Peng, Yang Long-Hai, Gu Li-Jia, Wang Jun-Ye
Department of Cardiothoracic Surgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P. R. China.
Ai Zheng. 2005 Oct;24(10):1249-51.
BACKGROUND & OBJECTIVE: With the developments in endoscopic surgery and the advances of radiological techniques, thoracoscopic pulmonary metastasectomy has been used more and more widely. This study was to evaluate the feasibility of thoracoscopic resection of pulmonary metastases.
The clinical data of 17 patients who underwent thoracoscopic pulmonary metastasectomy were retrospectively analyzed.
All pulmonary metastases in the 17 patients were peripherally located and encountered during follow-up after treatment of primary disease. Metastases at other sites were excluded. Among the 17 cases of metastases, 10 were solitary metastasis, 4 were unilateral multiple metastases, 3 were bilateral metastases. All patients underwent thoracoscopic wedge resection. No major complications, operative mortality, and port site metastasis presented. Postoperative locoregional relapse occurred in 5 patients, in which 4 patients had multiple metastases, the rest 1 patient with soft tissue sarcoma underwent a second thoracoscopic resection of recurrent pulmonary lesion. The 1-, 3-, and 5-year survival rates were 77.3%, 53.1%, and 34.8%, respectively.
Thoracoscopic resection is feasible and effective for patients with a solitary pulmonary metastasis, especially when the lesion is smaller than 3 cm and peripherally located. Bilateral pulmonary metastases may also be resected by primary thoracoscopic operation.
随着内镜手术的发展及放射技术的进步，胸腔镜肺转移瘤切除术的应用越来越广泛。本研究旨在评估胸腔镜切除肺转移瘤的可行性。
回顾性分析17例行胸腔镜肺转移瘤切除术患者的临床资料。
17例患者的所有肺转移瘤均位于周边，在原发疾病治疗后的随访期间发现，排除了其他部位的转移瘤。17例转移瘤中，10例为孤立性转移，4例为单侧多发转移，3例为双侧转移。所有患者均接受了胸腔镜楔形切除术。未出现严重并发症、手术死亡及切口种植转移。5例患者术后出现局部复发，其中4例为多发转移，另1例软组织肉瘤患者接受了胸腔镜下复发性肺病灶二次切除术。1年、3年和5年生存率分别为77.3%、53.1%和34.8%。
胸腔镜切除对孤立性肺转移瘤患者可行且有效，尤其是病灶小于3 cm且位于周边时。双侧肺转移瘤也可通过一期胸腔镜手术切除。
