Yim A P, Izzat M B, Liu H P, Ma C C
Department of Surgery, Prince of Wales Hospital, Hong Kong.
Semin Thorac Cardiovasc Surg. 1998 Oct;10(4):326-31. doi: 10.1016/s1043-0679(98)70035-8.
The application of video-assisted thoracic surgery (VATS) for major lung resection is controversial. We review our combined experience from three centers in Asia. From June 1993 through June 1997, 214 patients underwent VATS major resections (2 segmentectomies, 203 lobectomies, 6 bilobectomies, 3 pneumonectomies), mostly for primary malignancy. Stringent selection criteria were used to choose patients for this approach. We prefer a technique of not spreading ribs, using conventional thoracic instrument for dissection and routine use of wound protector for specimen retrieval. There was one postoperative surgical death and 47 non-fatal complications, which compare favorably with published series on open technique. Of the primary lung cancer patients, 93% are still alive after a mean follow-up of 26 months. We conclude that VATS major lung resection is technically feasible in selected patients and associated with favorable intermediate-term results.
电视辅助胸腔镜手术（VATS）用于主要肺切除术存在争议。我们回顾了来自亚洲三个中心的综合经验。从1993年6月至1997年6月，214例患者接受了VATS主要切除术（2例肺段切除术、203例肺叶切除术、6例双肺叶切除术、3例全肺切除术），大部分是针对原发性恶性肿瘤。采用严格的选择标准来挑选适合这种手术方式的患者。我们倾向于一种不撑开肋骨的技术，使用传统的胸腔器械进行解剖，并常规使用伤口保护器来取出标本。术后有1例手术死亡和47例非致命并发症，与已发表的开放手术系列相比结果良好。在原发性肺癌患者中，平均随访26个月后，93%的患者仍存活。我们得出结论，VATS主要肺切除术在选定患者中技术上是可行的，并且中期结果良好。
