Dai Wei, Mei Na, Ning Ye, Zhang Wentian, Li Yan, Jiang Lei
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, No. 507 Zhengmin Road, Shanghai, 200433, China.
Department of Thoracic Surgery, Sichuan Cancer Hospital, No. 55, Section 4, South Renmin Road, Chengdu, 610041, Sichuan, China.
J Surg Case Rep. 2024 Jan 4;2024(1):rjad620. doi: 10.1093/jscr/rjad620. eCollection 2024 Jan.
Accurate identification of the intersegmental plane is the key to successful segmentectomy. This case series included 41 patients who underwent uniportal thoracoscopic segmentectomy using the open insufflation method to identify the intersegmental plane for pulmonary nodules. The median age of the patients was 58 (range 35-73) years, and 63.4% were female. Malignant pulmonary nodules accounted for 80.5% of cases and were staged as 0-IA2. Seventeen patients underwent a single subsegmentectomy or single segmentectomy, and 24 underwent combined subsegmentectomy or subsegmentectomy combined with segmentectomy. There was no conversion to multiportal video-assisted thoracoscopic surgery, open surgery, or lobectomy. The median operative time was 84 (range 45-194) min, and the median blood loss was 50 (range 10-150) ml. The median chest tube duration and postoperative hospital stay were 2 (range 1 - 7) days. One (2.4%) developed an air leak for >5 days. No deaths occurred within 30 days after surgery.
准确识别肺段间平面是成功进行肺段切除术的关键。本病例系列纳入了41例行单孔胸腔镜肺段切除术的患者,采用开放通气法识别肺结节的肺段间平面。患者的中位年龄为58岁(范围35 - 73岁),女性占63.4%。恶性肺结节占病例的80.5%,分期为0 - IA2期。17例患者接受了单亚肺段切除术或单肺段切除术,24例接受了联合亚肺段切除术或亚肺段切除术联合肺段切除术。无病例转为多孔电视辅助胸腔镜手术、开放手术或肺叶切除术。中位手术时间为84分钟(范围45 - 194分钟),中位失血量为50毫升(范围10 - 150毫升)。胸腔引流管留置时间和术后住院时间的中位数分别为2天(范围1 - 7天)。1例(2.4%)出现漏气超过5天。术后30天内无死亡病例。