Dolci Giampiero, Campisi Alessio, Giunta Domenica, Congiu Stefano, Daddi Niccolò, Murana Giacomo, Dell'Amore Andrea
Department of CardioThoracic and Vascular Surgery, University Hospital S. Orsola Malpighi, Bologna, Italy.
J Vis Surg. 2017 Dec 14;3:187. doi: 10.21037/jovs.2017.11.07. eCollection 2017.
Video-assisted thoracoscopic surgery (VATS) has become a common surgical approach in the diagnosis and treatment of lung and mediastinal diseases. In this study, we reported our current experience of thoracoscopic surgery using a new caudal position technique for anatomical lung resections and compared it with the standard anterior VATS technique.
From January 2016 to October 2017, 92 consecutive patients with lung cancer underwent VATS lobectomy. Among these, 34 patients were treated by conventional anterior three portal VATS lobectomy, and 58 patients were treated using the caudal three port VATS lobectomy. The mean operative time, conversion rate, hospital stay, post-operative drainage, reoperation, post operative pain were compared between each group.
No differences between the two groups are showed in terms of surgical time, post-operative drainage, incidence of prolonged air leaks and post-operative pain.
The caudal approach to major pulmonary resection of thoracoscopic lobectomy results in a reliable and comfortable procedure for the surgeon. Once demonstrated the reliability of the VATS lobectomy with three accesses using the caudal position, we are starting to standardize biportal and uniportal VATS with the surgeon in the caudal position.
电视辅助胸腔镜手术（VATS）已成为诊断和治疗肺部及纵隔疾病的常用手术方法。在本研究中，我们报告了使用新的尾侧位技术进行解剖性肺切除的胸腔镜手术的当前经验，并将其与标准的前入路VATS技术进行比较。
2016年1月至2017年10月，92例连续肺癌患者接受了VATS肺叶切除术。其中，34例患者接受传统的前入路三孔VATS肺叶切除术，58例患者接受尾侧三孔VATS肺叶切除术。比较两组患者的平均手术时间、中转率、住院时间、术后引流、再次手术情况及术后疼痛情况。
两组在手术时间、术后引流、持续性漏气发生率及术后疼痛方面均无差异。
胸腔镜肺叶切除术中采用尾侧入路进行主要肺切除，对外科医生来说是一种可靠且舒适的手术方式。一旦证明了采用尾侧位三通道VATS肺叶切除术的可靠性，我们开始将双孔和单孔VATS与处于尾侧位的外科医生的操作进行标准化。
