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单孔电视辅助胸腔镜手术中的手套手指提取技术

Glove-Finger Extraction Technique in Uniportal Video-Assisted Thoracoscopic Surgery.

作者信息

Liu Yu-Wei, Tsai Dong-Lin, Li Hsien-Pin, Lin Chia-Jung, Lee Jui-Ying, Chou Shah-Hwa

机构信息

1 Division of Thoracic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University , Kaohsiung, Taiwan .

2 Department of Respiratory Therapy, College of Medicine, Kaohsiung Medical University , Kaohsiung, Taiwan .

出版信息

J Laparoendosc Adv Surg Tech A. 2017 Aug;27(8):795-798. doi: 10.1089/lap.2017.0216. Epub 2017 Jun 28.

Abstract

BACKGROUND

Uniportal video-assisted thoracoscopic surgery (VATS) is increasingly being performed worldwide. During the operation, specimen extraction from a small incision less than or equal to 2 cm can be challenging without the use of a commercial specimen retrieval device. There have been no reports regarding the use of the glove-finger technique in uniportal VATS. The aim of this study was to assess the feasibility of the alternative specimen retrieval method by glove-finger technique.

METHODS

We retrospectively investigated 50 patients with peripheral lung lesions who underwent uniportal VATS wedge resection with a 2-cm incision at Kaohsiung Medical University Hospital between August 2015 and December 2016. The cut end of the glove-finger was used to extract the specimen.

RESULTS

Fifty-five wedge-resected specimens were extracted successfully by glove-finger technique. There was no conversion to two-port nor three-port VATS. After intraoperative frozen section analysis for all specimens, 24 were revealed to have primary lung cancer and subsequently underwent completion lobectomy or segmentectomy; the other 31 showed 10 pulmonary metastases, 9 pulmonary benign lesions, and 12 pulmonary infectious lesions. All specimens were resected with free margins and the mean diameter of the lesions was 1.64 ± 0.59 cm (range: 0.2-2.6 cm) by pathological examination. No intraoperative complication related to the technique was observed.

CONCLUSIONS

This is the first study to reveal the efficacy and benefits of the glove-finger extraction technique in uniportal VATS. In our preliminary experience, this method can decrease costs without compromising the quality and safety of patient care.

摘要

背景

单孔电视辅助胸腔镜手术(VATS)在全球范围内的开展越来越广泛。在手术过程中,如果不使用商用标本取出装置,从小于或等于2厘米的小切口中取出标本可能具有挑战性。目前尚无关于在单孔VATS中使用手套手指技术的报道。本研究的目的是评估通过手套手指技术进行替代标本取出方法的可行性。

方法

我们回顾性研究了2015年8月至2016年12月期间在高雄医学大学附属医院接受单孔VATS楔形切除术且切口为2厘米的50例周围型肺病变患者。使用手套手指的切口端取出标本。

结果

通过手套手指技术成功取出了55个楔形切除标本。没有转为双孔或三孔VATS。对所有标本进行术中冰冻切片分析后,发现24例患有原发性肺癌,随后接受了完整的肺叶切除术或肺段切除术;另外31例显示10例肺转移、9例肺良性病变和12例肺部感染性病变。所有标本均切缘阴性,病理检查显示病变的平均直径为1.64±0.59厘米(范围:0.2 - 2.6厘米)。未观察到与该技术相关的术中并发症。

结论

这是第一项揭示手套手指取出技术在单孔VATS中的有效性和益处的研究。根据我们的初步经验,这种方法可以降低成本,同时不影响患者护理的质量和安全性。

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