Yim A P, Ko K M, Ma C C, Chau W S, Kyaw K
Department of Surgery, Chinese University of Hong Kong, Shatin, NT.
Chest. 1996 Feb;109(2):554-6. doi: 10.1378/chest.109.2.554.
The few reports in the literature on thoracoscopic anatomic lung resections were almost exclusively for early primary lung cancers. We report our combined experience on video-assisted thoracoscopic (VAT) lobectomy for benign diseases from two major hospitals in Hong Kong over a 20-month period. From August 1993 to March 1995, 66 VAT lobectomies were performed; of this number, 10 cases (15%) were for benign diseases (5 tuberculosis, 2 organized pneumonia, 1 bronchiectasis, 1 sclerosing hemangioma, 1 infected bronchogenic cyst). There was no mortality or incidence of intraoperative complications. Postoperative complications occurred in one patient with tuberculosis and consisted of persistent air leak and subsequent wound infection. There were no long-term complications after a mean follow-up of 11 months. The mean duration of chest tube drainage was 6.7 days and that of hospital stay was 9.8 days. These results were not statistically different from those achieved in VAT lobectomies performed for malignant tumors (5.0 days for drainage and 6.8 days for hospital stay) despite the fact that hilar dissection was sometimes more difficult in the former because of inflammatory changes. We conclude that VAT lobectomy for benign diseases is technically feasible even though its role in thoracic surgery remains to be defined.
文献中关于胸腔镜解剖性肺切除术的报道几乎都仅针对早期原发性肺癌。我们报告了香港两家主要医院在20个月期间对良性疾病行电视辅助胸腔镜(VAT)肺叶切除术的综合经验。1993年8月至1995年3月,共进行了66例VAT肺叶切除术;其中10例(15%)为良性疾病(5例肺结核、2例机化性肺炎、1例支气管扩张、1例硬化性血管瘤、1例感染性支气管囊肿)。无死亡病例及术中并发症发生。1例肺结核患者出现术后并发症,包括持续漏气及随后的伤口感染。平均随访11个月后无长期并发症。胸腔闭式引流的平均时间为6.7天,住院时间为9.8天。尽管由于炎症改变,前者的肺门解剖有时更困难,但这些结果与对恶性肿瘤行VAT肺叶切除术的结果(引流5.0天,住院6.8天)在统计学上无差异。我们得出结论,尽管VAT肺叶切除术在胸外科中的作用尚待明确,但对良性疾病行VAT肺叶切除术在技术上是可行的。