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单孔胸腔镜手术可作为选择性胸腔镜手术的一线治疗方法。

Single-port thoracoscopic surgery can be a first-line approach for elective thoracoscopic surgery.

作者信息

Chen C-H, Chang H, Lee S-Y, Liu H-C, Hung T-T, Huang W-C

机构信息

Graduate Institute of Mechanical and Electrical Engineering, National Taipei University of Technology, Taipei, Taiwan.

出版信息

Rev Port Pneumol. 2012 Nov-Dec;18(6):278-84. doi: 10.1016/j.rppneu.2012.05.001. Epub 2012 Sep 23.

Abstract

BACKGROUND

Thoracoscopic surgery has become very popular in recent years. Conventional thoracoscopic surgery requires three or more port wounds for manipulations of endoscopic instruments. For complicated cancer surgery, more port wounds and a larger thoracotomy wound may be required due to technical reasons. We want to investigate the effectiveness of single-port thoracoscopic approach in elective thoracoscopic surgery for thoracic disease.

MATERIALS AND METHODS

From July 1st, 2010 to March 31, 2011, 90 consecutive patients underwent general thoracoscopic surgery performed by the same thoracic surgeon. Two patients with severe trauma and massive bleeding were excluded from the study. All patients included had thoracoscopic surgery with a single-port approach. The surgical outcomes, complications, mortality and conversion rates were recorded and analyzed.

RESULTS

A total of 88 patients were included in this study. All these patients were operated on by the same surgeon. For sixty-eight patients, the single-port thoracoscopic approach was used. Nineteen patients were changed to a two-port thoracoscopic approach and one patient's was changed to mini-thoracotomy. Two patients died from terminal lung cancer and severe mitral regurgitation. Complications occurred in six cases. Eighty-seven patients (98.8%) were effectively managed with either single-port or a two-port approach. Only one patient was managed by mini-thoracotomy.

CONCLUSION

Elective thoracoscopic surgery performed through a single-port wound is feasible. Single-incisional thoracoscopic surgery can be safely applied as a first-line approach in most cases of elective thoracoscopic procedures.

摘要

背景

近年来,胸腔镜手术已变得非常流行。传统胸腔镜手术需要三个或更多的切口来操作内镜器械。对于复杂的癌症手术,由于技术原因可能需要更多的切口和更大的开胸切口。我们想要研究单孔胸腔镜手术方法在择期胸腔镜治疗胸部疾病中的有效性。

材料与方法

从2010年7月1日至2011年3月31日,90例连续患者接受了由同一位胸外科医生进行的普通胸腔镜手术。两名严重创伤和大出血患者被排除在研究之外。所有纳入患者均采用单孔胸腔镜手术方法。记录并分析手术结果、并发症、死亡率和中转率。

结果

本研究共纳入88例患者。所有这些患者均由同一位外科医生进行手术。68例患者采用单孔胸腔镜手术方法。19例患者改为双孔胸腔镜手术方法,1例患者改为小切口开胸手术。两名患者死于晚期肺癌和严重二尖瓣反流。6例发生并发症。87例患者(98.8%)通过单孔或双孔手术方法得到有效治疗。只有1例患者采用小切口开胸手术治疗。

结论

通过单一切口进行择期胸腔镜手术是可行的。在大多数择期胸腔镜手术病例中,单切口胸腔镜手术可作为一线手术方法安全应用。

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