用于胸腔镜肺叶切除术的柔性视频内窥镜：单孔技术的演变
Flexible videoscope for thoracoscopic lobectomy: evolution of uniportal technique.
作者信息
Ibrahim Mohsen, Menna Cecilia, Andreetti Claudio, D'Andrilli Antonio, Ciccone Anna Maria, Maurizi Giulio, Cassiano Francesco, Rendina Erino Angelo
机构信息
Division of Thoracic Surgery, Faculty of Medicine and Psychology, Sant'Andrea Hospital, University of Rome "Sapienza", Via di Grottarossa 1035, 00189, Rome, Italy,
出版信息
Surg Endosc. 2015 Jul;29(7):2056-9. doi: 10.1007/s00464-014-3865-3. Epub 2014 Oct 8.
BACKGROUND
Over the years reducing the number of ports during Video-assisted thoracic surgery (VATS) has allowed to accomplish pulmonary lobectomy with a single incision. Endoscopic view and instruments maneuvers issues could be improved by using flexible endoscope. We report our experience of fifteen uniportal VATS (UVATS) using a flexible thoracoscope.
METHODS
A single incision of about 4-5 cm long was performed at the 5th intercostal space along the anterior axillary line. No additional skin incisions were made. A flexible videoscope and multiple VATS instruments were simultaneously inserted into the uniport. Pulmonary lobectomy with systematic mediastinal lymph node dissection was performed. Verbal pain scores were registered using the visual analog scale from 0 to 10 at the first post-operative day.
RESULTS
No post-operative complications or hospital mortality were recorded. Mean operative time was 112.6 min (range 70-200) and mean postoperative hospital stay 3.2 days (range 2-6). Mean pain score was 0.5 (range 0-2).
CONCLUSIONS
Single-incision VATS lobectomy using a flexible thoracoscope is a feasible and safe approach.
背景
多年来，减少电视辅助胸腔镜手术（VATS）中的切口数量已使得通过单一切口完成肺叶切除术成为可能。使用可弯曲内窥镜可改善内镜视野和器械操作问题。我们报告了使用可弯曲胸腔镜进行15例单孔VATS（UVATS）的经验。
方法
在腋前线第5肋间进行一个约4 - 5厘米长的单一切口。未做额外的皮肤切口。将可弯曲视频镜和多个VATS器械同时插入单孔中。进行了系统性纵隔淋巴结清扫的肺叶切除术。术后第一天使用视觉模拟量表记录0至10分的言语疼痛评分。
结果
未记录到术后并发症或医院死亡率。平均手术时间为112.6分钟（范围70 - 200分钟），平均术后住院时间为3.2天（范围2 - 6天）。平均疼痛评分为0.5分（范围0 - 2分）。
结论
使用可弯曲胸腔镜进行单切口VATS肺叶切除术是一种可行且安全的方法。
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