电视辅助胸腔镜手术切除肺结节。胸腔外科组。

Resection of pulmonary nodules using video-assisted thoracic surgery. The Thorax Group.

作者信息

Bernard A

机构信息

Clinique Chirurgicale Universitaire, Hôpital du Bocage, Dijon, France.

出版信息

Ann Thorac Surg. 1996 Jan;61(1):202-4; discussion 204-5. doi: 10.1016/0003-4975(95)01014-9.

DOI:10.1016/0003-4975(95)01014-9

PMID:8561553

Abstract

BACKGROUND

The aim of this study was to assess the experience with video-assisted thoracic surgery for the resection of pulmonary nodules.

METHODS

This voluntary registry (20 centers) included 388 patients with either benign (n = 171) or malignant (n = 217) pulmonary nodules. Pulmonary nodules were located using computed tomography scan-guided injection of methylene blue (59 patients) and hook wire technique (17 patients).

RESULTS

Video-assisted thoracic surgery was converted into thoracotomy in 67 patients (17%) because of technical-emergency in 4, inability to complete resection in 33, and the need to perform lobectomy for cancer through thoracotomy in 30. In other patients, video-assisted thoracic surgery allowed wedge resection in 300 cases and lobectomy in 21 cases. No intraoperative and two postoperative deaths (0.56%) occurred. The complication rate was 8% (n = 31). Mean durations of chest tube placement and hospital stay were 3.3 days (range, 1 to 20 days) and 6 days (range, 1 to 25 days), respectively. Video-assisted thoracic surgery was judged by the surgeon to be a diagnostic procedure 226 times (58%) and a therapeutic procedure 162 times (42%).

CONCLUSION

Video-assisted thoracic surgery appears to be safe and remains mainly a diagnostic procedure for malignant tumors.

摘要

背景

本研究旨在评估电视辅助胸腔镜手术切除肺结节的经验。

方法

这个自愿登记研究（20个中心）纳入了388例患有良性（n = 171）或恶性（n = 217）肺结节的患者。通过计算机断层扫描引导注射亚甲蓝（59例患者）和钩丝技术（17例患者）来定位肺结节。

结果

67例患者（17%）中转开胸手术，其中4例因技术紧急情况，33例因无法完成切除，30例因需通过开胸行癌症肺叶切除术。在其他患者中，电视辅助胸腔镜手术300例行楔形切除术，21例行肺叶切除术。术中无死亡，术后2例死亡（0.56%）。并发症发生率为8%（n = 31）。胸腔引流管放置的平均时间和住院时间分别为3.3天（范围1至20天）和6天（范围1至25天）。外科医生认为电视辅助胸腔镜手术226次（58%）为诊断性操作，162次（42%）为治疗性操作。