Hashimi Habiba, Cooke David T, Holmes Sarah K, Brown Lisa M, David Elizabeth A
School of Medicine, University of California Davis, Sacramento, CA, USA.
Section of General Thoracic Surgery, Department of General Surgery, University of California, Davis Medical Center, Sacramento, CA, USA.
J Vis Surg. 2016 Mar 28;2:67. doi: 10.21037/jovs.2016.03.12. eCollection 2016.
Although video-assisted thoracoscopic surgery (VATS) initially demonstrated slow adoption amongst thoracic surgeons, VATS is now widely accepted and the techniques are associated with equivalent nodal dissection and, improved perioperative morbidity and, in some cases, superior perioperative survival compared to thoracotomy. Using a video-assisted, minimal access technique that requires marginal or no rib spreading, VATS provides improved postoperative pain and decreased time-to-recovery after surgery. However, complex resective cases, such as pneumonectomy, are not commonly accomplished minimally invasively. We share the surgical technique for VATS pneumonectomy based on our experience.
A 71-year-old patient underwent VATS pneumonectomy for synchronous, ipsilateral primary non-small cell lung cancer (NSCLC).
Our patient had no perioperative complications and was discharged to home on postoperative day 4. The patient's pain was managed with oral analgesics. Greater than ten lymph nodes were examined, all margins were negative for residual tumor. The patient did not require adjuvant radiation or chemotherapy.
VATS pneumonectomy is a safe and effective procedure that provides many clinical benefits to the patient. Our results suggest that clinicians should consider VATS pneumonectomy for primary treatment of patients with synchronous primary lung cancers when appropriate.
尽管电视辅助胸腔镜手术（VATS）最初在胸外科医生中采用率较低，但如今已被广泛接受，并且与开胸手术相比，该技术在淋巴结清扫方面效果相当，围手术期发病率降低，在某些情况下围手术期生存率更高。VATS采用电视辅助的微创技术，只需轻微或无需撑开肋骨，术后疼痛减轻，恢复时间缩短。然而，复杂的切除手术，如肺切除术，通常难以通过微创方式完成。我们根据自身经验分享VATS肺切除术的手术技术。
一名71岁患者因同时性同侧原发性非小细胞肺癌（NSCLC）接受了VATS肺切除术。
我们的患者未出现围手术期并发症，术后第4天出院。患者通过口服镇痛药控制疼痛。检查了十多个淋巴结，所有切缘均无残留肿瘤。患者无需辅助放疗或化疗。
VATS肺切除术是一种安全有效的手术，为患者带来诸多临床益处。我们的结果表明，临床医生在适当的时候应考虑将VATS肺切除术作为同时性原发性肺癌患者的主要治疗方法。
