Lewis R J, Caccavale R J, Sisler G E, Bocage J P, Mackenzie J W
University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, University Thoracic Surgical Service, St. Peter's Medical Center, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, USA.
Zentralbl Chir. 1998;123(5):501-5.
A new technique for pulmonary lobectomy has been utilized for malignant lesions. Eighty-five consecutive patients with pulmonary neoplasms underwent a VATS non-rib spread Simultaneously Stapled Lobectomy. There were 34 males and 51 females with 61 adeno, 21 squamous, 2 large cell and 1 carcinoid tumor who underwent 18 left upper, 13 left lower, 20 right upper, 7 right middle and 27 right lower lobectomies. Forty-one mediastinoscopies were negative. Patients with positive mediastinoscopies were not selected for curative resection. At VATS exploration, 10 patients had positive nodes. All resected nodes were negative in the other patients. Every bronchoscopy was negative. Operating times averaged 84.5 minutes. No patient received a transfusion. Lesions ranged from 1 cm to 8 cms with an average size of 3.62 cms. Post-operative length of stay averaged 3.38 days. There was no surgical mortality, no hemorrhage, no transfusion and no conversion to an open case in the entire series. No bronchial, vascular or broncho vascular fistula occurred. Complications were minor from which all patients recovered completely. Survival seems similar to patients resected by traditional open techniques.
一种用于肺叶切除术的新技术已应用于恶性病变。85例连续性肺肿瘤患者接受了电视辅助胸腔镜手术(VATS)非肋骨撑开同步缝合肺叶切除术。其中男性34例,女性51例,腺癌61例,鳞癌21例,大细胞癌2例,类癌1例,分别接受了18例左上叶、13例左下叶、20例右上叶、7例右中叶和27例右下叶切除术。41例纵隔镜检查结果为阴性。纵隔镜检查阳性的患者未被选作根治性切除术。在电视辅助胸腔镜手术探查中,10例患者有阳性淋巴结。其他患者所有切除的淋巴结均为阴性。每次支气管镜检查均为阴性。手术时间平均为84.5分钟。无患者接受输血治疗。病变大小从1厘米至8厘米不等,平均大小为3.62厘米。术后住院时间平均为3.38天。整个系列中无手术死亡、无出血、无输血且无中转开胸病例。未发生支气管、血管或支气管血管瘘。并发症轻微,所有患者均完全康复。生存率似乎与采用传统开放技术切除的患者相似。