Furák József, Bács Ervin, Grochulski Radek, Wolfárd Antal, Szoke Tamás, Troján Imre, Csernay Edina, Lázár György
Szegedi Tudományegyetem, Sebészeti Klinika, 6726 Szeged, Thököly u. 20.
Magy Seb. 2008 Feb;61(1):29-32. doi: 10.1556/MaSeb.61.2008.1.6.
In this retrospective study, we present our experiences and results with lobectomy performed through video-assisted mini thoracotomy (VAMT), a technique that we have been using since 2006.
In the first half of 2006 10 video-assisted lobectomies were performed in our department. There were eight women and two men; the mean age was 61.4 (47-68) years. The indications for surgery were the following: benign lesions in three cases, T1N0 squamous lung cancers proved by cytology in six patients, and another case, when the CT suggested - but cytologically not proved - T1N0 lung cancer. After a double lumen endotracheal tube intubation and videothoracoscopic exploration, a 6-8 cm mini thoracotomy was performed. Manual palpation of the lung parenchyma, resection with mediastinal block dissection (in cases of malignancy) was carried out through a 2 cm wide rib spread, without rib resection. Five lower, four upper lobe lobectomies and one upper bilobectomy were performed. There was no perioperative mortality or serious morbidity detected. The mean operative time was 130 (80-200) minutes. The three benign lesions were hamartochondromas. The final histology revealed four T1N0 and two T2N2 stage squamous cell lung cancers, while one T1N2 small cell lung cancer was also found. Lobectomy performed through a video-assisted mini thoracotomy is a safe procedure. The manual palpation, parenchyma resection and mediastinal block dissection can be performed similarly to open procedures.
在这项回顾性研究中,我们介绍了自2006年以来一直使用的通过电视辅助小切口开胸手术(VAMT)进行肺叶切除术的经验和结果。
2006年上半年,我们科室进行了10例电视辅助肺叶切除术。其中有8名女性和2名男性;平均年龄为61.4岁(47 - 68岁)。手术指征如下:3例为良性病变,6例经细胞学证实为T1N0期肺鳞状细胞癌,另1例CT提示为T1N0期肺癌但细胞学未证实。在双腔气管插管和电视胸腔镜探查后,进行了6 - 8厘米的小切口开胸手术。通过2厘米宽的肋骨撑开器进行肺实质的手动触诊以及(恶性肿瘤病例)纵隔淋巴结清扫切除术,无需切除肋骨。进行了5例下叶、4例上叶肺叶切除术和1例上叶双肺叶切除术。未检测到围手术期死亡或严重并发症。平均手术时间为130分钟(80 - 200分钟)。3例良性病变均为错构瘤。最终组织学检查显示有4例T1N0期和2例T2N2期肺鳞状细胞癌,同时还发现1例T1N2期小细胞肺癌。通过电视辅助小切口开胸手术进行肺叶切除术是一种安全的手术方法。手动触诊、实质切除术和纵隔淋巴结清扫术的操作与开放手术相似。