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113例单操作孔胸腔镜肺叶切除术临床分析

[Analysis of single-operation-hole thoracoscopic lobectomy in 113 clinical cases].

作者信息

Xu Chun, Ma Haitao, Ni Bin, He Jingkang, Li Chang, Ding Cheng, Li Guangbin, Wang Yuxuan, Zhao Jun

机构信息

Department of Thoracic and Cardiovascular Surgery, the First Affiliated Hospital of Soochow University, Suzhou 215006, China.

出版信息

Zhongguo Fei Ai Za Zhi. 2014 May;17(5):424-7. doi: 10.3779/j.issn.1009-3419.2014.05.11.

Abstract

BACKGROUND AND OBJECTIVE

Video-assisted thoracoscopic surgery (VATS) lobectomy is generally accepted for patients with lung cancer. The aim of this study is to explore the feasibility of the single-operation-hole thoracoscopic lobectomy in the treatment of non-small cell lung cancer.

METHODS

To review and analyze the single-operation-hole thoracoscopic lobectomy performed in our hospital for 113 non-small cell lung cancer (NSCLC) cases from October 2010 to October 2013. The incision for observation was 1.5 cm the eighth intercostal at the rear of the midaxillary line and the incision for operation was 2.0 cm-4.0 cm at the fourth or fifth intercostal of the anterior axillary line. The operations were performed through the single-operation-hole.

RESULTS

The operation processes were smooth for all the patients without any operative mortality occurrence. Only in 5 cases was the operation hole expanded because of the occurrence of massive hemorrhage during the operation; 3 patients with postoperative complications underwent thoracoscopic lobectomy again, including 2 cases of delayed hemorrhage and 1 case of chylothorax. The average surgical duration was (178.24±31.17) min, the average blood loss was (213.56±62.38) mL, and the number of lymph nodes dissected was from 5-22. All diagnose were confirmed by pathology after operation. The average length of stay was (8.17±2.93) d. All cases recovered well during the follow-up of (2-38) months, only 5 cases had recurrence or metastasis.

CONCLUSIONS

The single-operation-hole thomcoscopic lobectomy for lung cancer is safe and feasible, further reducing the trauma, and can be used as a conventional treatment for early- or medium-term NSCLC.

摘要

背景与目的

电视辅助胸腔镜手术(VATS)肺叶切除术已被肺癌患者广泛接受。本研究旨在探讨单操作孔胸腔镜肺叶切除术治疗非小细胞肺癌的可行性。

方法

回顾分析我院2010年10月至2013年10月对113例非小细胞肺癌(NSCLC)患者施行的单操作孔胸腔镜肺叶切除术。观察孔位于腋中线后方第8肋间,长1.5 cm;操作孔位于腋前线第4或第5肋间,长2.0 cm - 4.0 cm。所有手术均通过单操作孔完成。

结果

所有患者手术过程顺利,无手术死亡病例。仅5例因术中出现大出血而扩大手术切口;3例术后出现并发症的患者再次行胸腔镜肺叶切除术,其中2例为迟发性出血,1例为乳糜胸。平均手术时间为(178.24±31.17)分钟,平均出血量为(213.56±62.38)毫升,清扫淋巴结数为5 - 22枚。术后所有诊断均经病理证实。平均住院时间为(8.17±2.93)天。所有病例在(2 - 38)个月的随访中恢复良好,仅5例出现复发或转移。

结论

单操作孔胸腔镜肺癌肺叶切除术安全可行,进一步减少了创伤,可作为早中期NSCLC的常规治疗方法。

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本文引用的文献

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