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[电视辅助胸腔小切口肺癌支气管袖状切除及肺动脉重建术]

[Bronchial sleeve resection and reconstruction of pulmonary artery by video-assisted thoracic small incision surgery for lung cancer].

作者信息

He Jianxing, Yang Yunyou, Chen Hanzhang, Wu Zhefan, Wei Bing, Shao Wenlong, Yin Weiqiang, Yang Dekang

机构信息

Department of Thoracic Surgery, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital, Guangzhou Medical College, Guangzhou, Guangdong 510120, P.R.China.

出版信息

Zhongguo Fei Ai Za Zhi. 2007 Aug 20;10(4):301-5. doi: 10.3779/j.issn.1009-3419.2007.04.09.

Abstract

BACKGROUND

The mini-invasive surgery is now performed widely and these operations have been used in complete resection of lung cancer. The aim of this study is to summarize the results and to explore practicability of bronchial sleeve resection and reconstruction of pulmonary artery by video-assisted thoracic small incision surgery for lung neoplasms.

METHODS

A total of 109 patients were retrospectively reviewed, who underwent sleeve lobectomy and bronchoplasty by video-assisted thoracic small incision surgery for lung neoplasms from January 1995 to December 2005.

RESULTS

Operations were performed successfully for all the patients. The small incisions' length ranged from 3 to 15 cm and the mean length was 10 cm. The surgical time was 125-180 min and the mean was 150 min; blood loss was 210-450 mL and the mean was 320 mL. There was no operative mortality, occurrence of anastomosis stenosis and fistula. Follow-up results showed that there was no sign of re-perfusion hurt and no edema in remaining lobes. There was no blood transfusion in 80.7% of cases (88/109), no shoulder hurt in 94.5% of cases (103/109). The stay in hospital was 7-15 days, and the average was 9 days.

CONCLUSIONS

The bronchial sleeve resection and reconstruction of pulmonary artery by video-assisted thoracic small incision surgery for lung cancer could finish the same work as traditional thoracic lateral incision, with less trauma, less bleeding and blood transfusion, less time in opening and closing thorax.

摘要

背景

微创外科手术目前已广泛开展,这些手术已用于肺癌的根治性切除。本研究的目的是总结电视辅助胸壁小切口手术治疗肺部肿瘤行支气管袖状切除及肺动脉重建的结果,并探讨其可行性。

方法

回顾性分析1995年1月至2005年12月期间,109例因肺部肿瘤行电视辅助胸壁小切口手术行袖状肺叶切除及支气管成形术的患者。

结果

所有患者手术均成功。小切口长度为3~15cm,平均长度为10cm。手术时间为125~180分钟,平均为150分钟;出血量为210~450ml,平均为320ml。无手术死亡、吻合口狭窄及瘘的发生。随访结果显示无再灌注损伤迹象,余肺无水肿。80.7%的病例(88/109)未输血,94.5%的病例(103/109)无肩部疼痛。住院时间为7~15天,平均为9天。

结论

电视辅助胸壁小切口手术治疗肺癌行支气管袖状切除及肺动脉重建与传统胸外侧切口手术效果相同,但创伤更小、出血及输血量更少、开胸及关胸时间更短。

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