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右上肺叶切除术的肺动脉和肺静脉简化同步离断法。

Simplified synchronous disconnection of pulmonary arteries and veins for right upper lobectomy.

机构信息

Department of Thoracic Surgery, First Affiliated Hospital of Fujian Medical University, #20 Chazhong Road, Fuzhou, 350005, Fujian, People's Republic of China.

Department of Geriatric Medicine, Fujian Provincial Hospital, Fujian Key Laboratory of Geriatrics, Fujian Provincial Center for Geriatrics, Fujian Medical University, Fuzhou, People's Republic of China.

出版信息

Surg Endosc. 2019 Jun;33(6):2015-2023. doi: 10.1007/s00464-018-06659-w. Epub 2019 Jan 7.

Abstract

BACKGROUND

Video-assisted thoracoscopic lobectomy with lymphadenectomy is considered one of the most effective treatments for early non-small cell lung cancer. We developed a novel approach for lobectomy in patients with right upper lung cancer through simplified synchronous disconnection of pulmonary arteries and veins. This study aimed to evaluate the feasibility, efficacy, safety, and cost-effectiveness of this minimally invasive technique in managing right upper lobectomy.

PATIENTS AND METHODS

From March 2016 to September 2017, 62 patients with right upper lung cancer underwent lobectomy via simplified synchronous disconnection of pulmonary arteriovenous by video-assisted thoracoscopic surgery. All patients were followed up for 6-12 months after the procedure through clinic visits or telephone/e-mail interviews.

RESULTS

Of the 62 patients (mean age, 57.2 ± 8.7 years), 28 were men (45.2%) and 34 (54.8%) were women. All procedures were successfully performed by thoracoscopy, with a mean operating time of 66.2 ± 9.0 min. The mean blood loss was 40.3 ± 19.5 mL. Only 1 (1.61%) patient required blood transfusion. The mean number of endoscopic linear stapling devices used was 2.6 ± 0.7. The mean number of lymph nodes harvested was 16.0 ± 1.6. Postoperative pneumonia was encountered in 4 (6.45%) patients. There was no postoperative mortality. The mean length of hospital stay was 5.3 ± 1.3 days. Six-month follow-up revealed an excellent clinical result and degree of satisfaction.

CONCLUSIONS

Simplified synchronous disconnection of pulmonary arteries and veins is a feasible, economical, safe, and effective therapeutic procedure for right upper lung carcinoma. This novel procedure shows promise as a viable surgical approach for right upper lobectomy.

摘要

背景

电视辅助胸腔镜肺叶切除术联合淋巴结清扫术被认为是治疗早期非小细胞肺癌最有效的方法之一。我们开发了一种通过简化同步分离肺动脉和静脉来进行右肺上叶切除术的新方法。本研究旨在评估这种微创技术在右肺上叶切除术管理中的可行性、疗效、安全性和成本效益。

患者和方法

2016 年 3 月至 2017 年 9 月,62 例右肺上叶癌患者通过电视辅助胸腔镜手术行简化同步肺动静脉分离肺叶切除术。所有患者在手术后通过门诊或电话/电子邮件访谈进行 6-12 个月的随访。

结果

62 例患者(平均年龄 57.2±8.7 岁)中,男性 28 例(45.2%),女性 34 例(54.8%)。所有手术均通过胸腔镜成功完成,平均手术时间为 66.2±9.0 分钟。平均出血量为 40.3±19.5ml。仅 1 例(1.61%)患者需要输血。平均使用内镜直线切割吻合器 2.6±0.7 个。平均采集淋巴结 16.0±1.6 个。术后肺炎 4 例(6.45%)。无术后死亡。平均住院时间为 5.3±1.3 天。6 个月随访显示临床效果和满意度均极佳。

结论

简化同步肺动静脉分离术是一种可行的、经济的、安全有效的右肺上叶癌治疗方法。这种新方法有望成为右肺上叶切除术的一种可行的手术方法。

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