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一家胸外科中心电视辅助胸腔镜手术肺叶切除术的首次经验及并发症

First experiences and complications in video-assisted thoracoscopic surgery lobectomy at a thoracic surgery center.

作者信息

Fındık Göktürk, İncekara Funda, Demiröz Mustafa, Sayılır Ebru, İnan Kubilay, Hazer Seray, Aydoğdu Koray, Kaya Sadi

机构信息

Department of Thoracic Surgery, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey.

出版信息

Turk Gogus Kalp Damar Cerrahisi Derg. 2018 Jan 9;26(1):116-122. doi: 10.5606/tgkdc.dergisi.2018.13641. eCollection 2018 Jan.

Abstract

BACKGROUND

This study aims to report the difficulties and complications we experienced in video-assisted thoracoscopic surgery lobectomies performed at our thoracic surgery center.

METHODS

A total of 76 patients (54 males, 22 females; mean age 48.3 years; range 9 to 83 years) who underwent video-assisted thoracoscopic surgery lobectomy between January 2012 and June 2016 were retrospectively reviewed. Preoperative patient characteristics such as additional diseases or tuberculosis history, stage for malignant diseases, surgical characteristics such as port properties and amount of bleeding, postoperative characteristics such as amount, time and duration of drainage, air leakage, and discharge time, morbidity and mortality rates, and their causes were evaluated.

RESULTS

Of the patients, 35 were evaluated due to benign pulmonary diseases and 41 due to malignant pulmonary diseases. Postoperative prolonged air leakage developed in 14 patients. Of these patients, one was administered thoracotomy and primary repair, three were administered pleurodesis, and three were administered secondary pleurocan catheter, while the air leakage ended spontaneously in seven patients. Due to bleeding, one patient was treated with revision video-assisted thoracoscopic surgery on the same day postoperatively. One patient developed chylothorax and one patient developed pneumonia, which caused respiratory failure.

CONCLUSION

Video-assisted thoracoscopic surgery lobectomy is a safe thoracic procedure, which is used for both oncologic and non-oncologic diseases of the lung. Video-assisted thoracoscopic surgery may be performed by all thoracic surgeons experienced in open thoracic surgery. Thanks to the gained experiences, the rates of video-assisted thoracoscopic surgery lobectomy may improve in all centers.

摘要

背景

本研究旨在报告我们胸外科中心在电视辅助胸腔镜手术肺叶切除术中遇到的困难和并发症。

方法

回顾性分析2012年1月至2016年6月期间接受电视辅助胸腔镜手术肺叶切除术的76例患者(男性54例,女性22例;平均年龄48.3岁;范围9至83岁)。评估术前患者特征,如合并疾病或结核病史、恶性疾病分期,手术特征,如切口性质和出血量,术后特征,如引流量、引流时间和持续时间、漏气情况及出院时间、发病率和死亡率及其原因。

结果

患者中,35例因良性肺部疾病接受评估,41例因恶性肺部疾病接受评估。14例患者术后出现持续性漏气。其中1例接受开胸手术及一期修复,3例接受胸膜固定术,3例置入胸腔闭式引流管,7例漏气自行停止。1例患者因出血在术后当天接受了电视辅助胸腔镜手术修正。1例患者发生乳糜胸,1例患者发生肺炎并导致呼吸衰竭。

结论

电视辅助胸腔镜手术肺叶切除术是一种安全的胸部手术,可用于治疗肺部肿瘤性和非肿瘤性疾病。所有有开胸手术经验的胸外科医生均可进行电视辅助胸腔镜手术。基于所积累的经验,各中心电视辅助胸腔镜手术肺叶切除术的成功率可能会提高。

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