Han Kook Nam, Kim Hyun Koo, Choi Young Ho
Department of Thoracic and Cardiovascular Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
J Thorac Dis. 2016 Mar;8(Suppl 3):S279-86. doi: 10.3978/j.issn.2072-1439.2016.02.31.
Single-port thoracoscopic segmentectomy is a challenging option in the early stages of lung cancer. The purpose of this study was to determine the feasibility of single-port video-assisted thoracoscopic surgery (VATS) segmentectomy compared to conventional multi-port VATS.
A total of 45 patients underwent pulmonary segmentectomy by video-assisted thoracoscopic surgery between March 2006 and October 2015. We analyzed the operative outcomes of segmentectomy by surgical approach (34 single-port versus 11 multi-port).
Twenty-three primary lung cancers (51.1%), 16 benign lung diseases (35.6%), and 6 secondary lung cancers (13.3%) were diagnosed and included in our study. In 29 malignancy cases (64.4%), the mean tumor size was 1.8±0.7 (range, 1-3.5) cm. Twenty patients (44.4%) underwent preoperative localization with hook-wire and radiocontrast. The most frequent operated segment was the left upper divisional segment (n=9, 30%). There was no significant difference in operation time (P=0.073), the number of dissected lymph nodes (P=0.310), intraoperative events (P=0.412), and the development of prolonged air leak (>5 days) (P=0.610) between the single-port and multi-port VATS segmentectomy groups. There was a reduction in postoperative morbidity (P<0.001) and hospital stay (P=0.029) in the single-port VATS group.
Single-port VATS segmentectomy for early lung cancer and benign lung disease, is a safe and feasible option for patients undergoing pulmonary segmentectomy.
单孔胸腔镜肺段切除术是早期肺癌治疗中一项具有挑战性的选择。本研究的目的是确定与传统多孔胸腔镜手术相比,单孔电视辅助胸腔镜手术(VATS)肺段切除术的可行性。
2006年3月至2015年10月期间,共有45例患者接受了电视辅助胸腔镜手术肺段切除术。我们通过手术方式(34例单孔与11例多孔)分析了肺段切除术的手术结果。
本研究共纳入并诊断出23例原发性肺癌(51.1%)、16例良性肺部疾病(35.6%)和6例继发性肺癌(13.3%)。在29例恶性肿瘤病例(64.4%)中,平均肿瘤大小为1.8±0.7(范围1-3.5)cm。20例患者(44.4%)术前采用钩丝和放射性造影剂进行了定位。最常进行手术的肺段是左上叶前段(n = 9,30%)。单孔与多孔VATS肺段切除术组在手术时间(P = 0.073)、清扫淋巴结数量(P = 0.310)、术中情况(P = 0.412)以及持续性漏气(>5天)发生率(P = 0.610)方面无显著差异。单孔VATS组术后并发症发生率(P < 0.001)和住院时间(P = 0.029)有所降低。
对于早期肺癌和良性肺部疾病患者,单孔VATS肺段切除术是一种安全可行的肺段切除选择。