针式内镜辅助单孔电视胸腔镜肺解剖性肺段切除术
Needlescopic-assisted uniportal video-assisted thoracoscopic pulmonary anatomical segmentectomy.
作者信息
Yang Shun-Mao, Wu Wen-Ting, Liu Yu-Hsuan, Ko Huan-Jang
机构信息
Department of Surgery, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu City, Taiwan.
出版信息
J Vis Surg. 2017 Sep 30;3:138. doi: 10.21037/jovs.2017.08.20. eCollection 2017.
BACKGROUND
Pulmonary segmentectomy can be an oncologic equivalent of lobectomy for small non-small cell lung cancer. Uniportal video-assisted thoracoscopic surgery (VATS) has recently showed favorable surgical outcomes, but remains technical demanding, especially in a complex procedure like anatomic segmentectomy. This manuscript demonstrates the surgical techniques for uniportal VATS segmentectomies with the assistance of additional needlescopic instruments.
METHODS
Data of 22 consecutive patients who underwent 24 needlescopic-assisted uniportal VATS segmentectomies between December 2016 and June 2017 was analyzed.
RESULTS
There were 12 uni-segmentectomies, 10 bi-segmentectomies, and 2 tri-segmentectomies. The mean operation time was 178.3 minutes. The mean duration of chest tube drainage was 5.2 days, and the mean duration of hospital stay was 7.4 days. There were two episodes of major bleeding and one case that required conversion to lobectomy.
CONCLUSIONS
Under the assistance of additional needlescopic instruments, segmentectomy can be performed more easily and safely with uniportal VATS.
背景
对于小的非小细胞肺癌，肺段切除术在肿瘤学上可等同于肺叶切除术。单孔电视辅助胸腔镜手术（VATS）近来显示出良好的手术效果，但技术要求仍然较高，尤其是在解剖性肺段切除术这样的复杂手术中。本文展示了在额外的针式内镜器械辅助下进行单孔VATS肺段切除术的手术技巧。
方法
分析了2016年12月至2017年6月期间连续22例接受24次针式内镜辅助单孔VATS肺段切除术患者的数据。
结果
有12例单段切除术、10例双段切除术和2例三段切除术。平均手术时间为178.3分钟。胸腔闭式引流平均持续时间为5.2天，平均住院时间为7.4天。发生了2次大出血事件，1例需要转为肺叶切除术。
结论
在额外的针式内镜器械辅助下，单孔VATS肺段切除术可以更轻松、安全地进行。
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