Liu Lunxu, Mei Jiandong, Pu Qiang, Ma Lin
Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China.
Eur J Cardiothorac Surg. 2014 Sep;46(3):493-5. doi: 10.1093/ejcts/ezu103. Epub 2014 Mar 14.
We present our preliminary experience of thoracoscopic bronchovascular double sleeve lobectomy (SL) for non-small-cell lung cancer in the upper lobe involving both the bronchus and the pulmonary artery. From May 2012 to July 2013, 4 patients were selected for this operation, including 3 cases of left upper lobectomy and 1 case of right upper lobectomy. Surgical procedures were performed with four ports for the first patient and three ports for the other patients. Systemic lymph node dissection was finished before removal of the diseased lobe. Thoracoscopic bronchovascular reconstruction was carried out using running Prolene stitches by directly watching a video monitor. The operations were uneventful. Two patients developed postoperative pneumonia with no mortalities. The reconstructed bronchus and artery worked well during postoperative follow-up visits. Though technically difficult, we believe that thoracoscopic bronchovascular SL is feasible if performed by skilled thoracoscopic surgeons in an experienced centre.
我们介绍了胸腔镜支气管血管双袖式肺叶切除术(SL)治疗上叶非小细胞肺癌累及支气管和肺动脉的初步经验。2012年5月至2013年7月,选择4例患者进行该手术,包括3例左上叶切除术和1例右上叶切除术。第1例患者采用四孔法进行手术,其他患者采用三孔法。在切除病变肺叶前完成系统性淋巴结清扫。通过直接观察视频监视器,使用普理灵缝线连续缝合进行胸腔镜支气管血管重建。手术过程顺利。2例患者术后发生肺炎,无死亡病例。重建的支气管和动脉在术后随访期间功能良好。虽然技术难度较大,但我们认为,如果由经验丰富的胸腔镜外科医生在经验丰富的中心进行,胸腔镜支气管血管双袖式肺叶切除术是可行的。