Yang Hee Chul, Noh Dongsub
1 Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea ; 2 Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea ; 3 Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Seoul, Korea.
J Thorac Dis. 2015 May;7(5):E122-5. doi: 10.3978/j.issn.2072-1439.2015.04.59.
Single incision thoracoscopic surgery (SITS) involves only one intercostal space with minimal skin incision, which means it can be the most minimally invasive technique up to date. We minimized the skin incision to a length of 2.5 cm to achieve the less chest wall trauma and the more cosmesis during SITS lobectomy for benign pulmonary disease. Four patients who had bronchiectasis [left lower lobe (LLL)], congenital lobar emphysema [left upper lobe (LUL)], aspergilloma [right upper lobe (RUL)], and hamartoma (RUL) were planned to undergo 2.5 cm SITS lobectomy. There were no conversion cases to multi-port video-assisted thoracic surgery (VATS) or thoracotomy. The mean operation time was 182±25 minutes. Chest drains were removed on postoperative day (POD) 2 in all patients. Three patients discharged on POD 3. One patient who discharged on POD 5 readmitted for delayed pleural effusion and treated with mini-tube insertion. There were no late complications or symptom relapses during the median follow-up of 13.5 months. A 2.5 cm SITS lobectomy can be alternative option for relatively young patients with benign lung disease.
单切口胸腔镜手术(SITS)仅通过一个肋间间隙进行,皮肤切口极小,这意味着它可能是目前最微创的技术。在对良性肺部疾病进行SITS肺叶切除术时,我们将皮肤切口最小化至2.5厘米,以减少胸壁创伤并提高美观度。计划对4例患有支气管扩张(左下叶)、先天性肺叶气肿(左上叶)、曲菌球(右上叶)和错构瘤(右上叶)的患者进行2.5厘米的SITS肺叶切除术。没有转为多端口电视辅助胸腔镜手术(VATS)或开胸手术的病例。平均手术时间为182±25分钟。所有患者均在术后第2天拔除胸腔引流管。3例患者在术后第3天出院。1例在术后第5天出院的患者因延迟性胸腔积液再次入院并接受了微管插入治疗。在13.5个月的中位随访期内,没有出现晚期并发症或症状复发。对于相对年轻的良性肺病患者,2.5厘米的SITS肺叶切除术可以作为一种替代选择。