单孔电视辅助胸腔镜肺切除手术的临床应用(附100例报告)

doi:10.13481/j.1671-587x.20150132

吉林大学学报(医学版) ›› 2015, Vol. 41 ›› Issue (01): 165-168.doi: 10.13481/j.1671-587x.20150132

单孔电视辅助胸腔镜肺切除手术的临床应用(附100例报告)

贾腾, 李洋, 张科伟, 高新亮, 张克剑, 刘伟

吉林大学第一医院胸外科, 吉林长春 130021

收稿日期:2014-09-17 发布日期:2015-01-30
通讯作者: 刘伟,教授,主任医师,博士研究生导师(Tel:0431-81875309,E-mail:davidliuw@hotmail.com) E-mail:davidliuw@hotmail.com
作者简介:贾腾(1987-),男,山东省泰安市人,在读医学硕士,主要从事肺癌多学科诊疗方面的临床研究。
基金资助:
卫生与计划生育委员会科研项目资助课题(W2011FAI16)

Clinical application of uniportal video-assisted thoracoscopic pulmonary resection with 100 cases report

JIA Teng, LI Yang, ZHANG Kewei, GAO Xinliang, ZHANG Kejian, LIU Wei

Department of Thoracic Surgery, First Hospital, Jilin University, Changchun 130021, China

Received:2014-09-17 Published:2015-01-30

摘要/Abstract

摘要：

目的: 探讨单孔电视辅助胸腔镜肺切除手术治疗肺部疾病的可行性,为其在胸外科临床中的应用提供经验。方法: 2013年3月—2014年9月本科采用单孔电视辅助胸腔镜行肺切除手术(肺叶切除术和限局性肺切除术)治疗肺部疾病100例,对全部病例的临床资料进行回顾性分析。结果: 全组100例患者中男性39例,女性61例,平均年龄(54.6±10.9)岁;成功行单孔电视辅助胸腔镜肺叶切除术52例,限局性肺切除术44例,4例分别因肺门黏连严重(1例)和术中难以控制的出血(叶间肺动脉破裂2例,肺静脉破裂1例)而中转开胸手术。术后病理诊断为非小细胞肺癌患者63例,肺良性疾病患者37例,平均手术时间(124±66)min,术中平均出血量(100±65) mL,平均胸腔引流时间(4.1±3.0)d,平均住院时间(8.3±3.6)d,术后无围术期并发症,无术后30 d内死亡,所有患者均康复出院。结论: 单孔电视辅助胸腔镜肺切除手术是一种安全、可行的微创手术新方式,值得在胸外科临床推广应用。

关键词: 单孔电视辅助胸腔镜手术, 肺叶切除术, 限局性肺切除术

Abstract:

Objective To study the feasibility of uniportal video-assisted thoracoscopic pulmonary resection in treatment of lung diseases, and to provide our experience in the application of this new technique. Methods 100 patients with lung diseases were underwent uniportal video-assisted thoracoscopic pulmonary resection (lobectomy and limited resection) from March 2013 to September 2014, and the clinical data in all patients were retrospectively analyzed. Results There were 39 male, 61 female and the average age was (54.6±10.9) years in the total 100 patients.The uniportal video-assisted thoracoscopic lobectomy and limited pulmonary resection were successfully performed in 52 and 44 patients respectively.There were only 4 cases converted into thoracotomy because of the severe hila adhesion (1 case) and uncontrolled intraoperative hemorrhage (2 for interlobar pulmonary artery rupture and 1 for pulmonary vein rupture).The mean operative time was (124±66)min, the mean intraoperative blood loss was (100±65) mL, the mean thoracic drainage time was (4.1±3.0) d, and the mean hospital stay was (8.3±3.6) d.All patients were discharged uneventfully without perioperative complications and postoperative death in 30 d. Conclusion The uniportal video-assisted thoracoscopic pulmonary resection is a safe and feasible new method of minimally invasive technique, and it is worthy to apply in thoracic surgery.

Key words: uniportal video-assisted thoracoscopic surgery, lobectomy, limited pulmonary resection

中图分类号:

R655.3

贾腾, 李洋, 张科伟, 高新亮, 张克剑, 刘伟. 单孔电视辅助胸腔镜肺切除手术的临床应用(附100例报告)[J]. 吉林大学学报(医学版), 2015, 41(01): 165-168.

JIA Teng, LI Yang, ZHANG Kewei, GAO Xinliang, ZHANG Kejian, LIU Wei. Clinical application of uniportal video-assisted thoracoscopic pulmonary resection with 100 cases report[J]. Journal of Jilin University Medicine Edition, 2015, 41(01): 165-168.

参考文献

[1] Roviaro G,Rebuffat C,Varoli F,et al.Videoendoscopic pulmonary lobectomy for cancer [J].Surg Laparosc Endosc,1992,2 (3):244-247.

[2] Rocco G,Martin-Ucar A,Passera E.Uniportal VATS wedge pulmonary resections [J].Ann Thorac Surg,2004,77(2):726-728.

[3] Rocco G.Single port video-assisted thoracic surgery (uniportal) in the routine general thoracic surgical practice [J].Op Tech Thorac Cardiovasc Surg,2009,14(4): 326-335.

[4] Rocco G,Martucci N,La Manna C,et al.Ten-year experience on 644 patients undergoing single-port (unipotal) video-assisted thoracoscopic surgery[J].Ann Thorac Surg,2013,96(2):434-438.

[5] Gonzalez D,Paradela M,Garcia J,et al.Single-port video-assisted thoracoscopic lobectomy [J].Interact Cardiovasc Thorac Surg,2011,12(3):514-515.

[6] Balsara KR,Balderson SS,D'Amico TA.Surgical techniques to avoid parenchymal injury during lung resection (fissureless lobectomy) [J].Thorac Surg Clin,2010,20(3):365-369.

[7] Swanson SJ,Herndon JE 2nd,D'Amico TA,et al.Video-assisted thoracic surgery lobectomy: report of CALGB 39802--a prospective,multi-institution feasibility study [J].J Clin Oncol,2007,25(31):4993-4997.

[8] Ceppa DP,Kosinski AS,Berry MF,et al.Thoracoscopic lobectomy has increasing benefit in patients with poor pulmonary function: a Society of Thoracic Surgeons Database analysis[J].Ann Surg,2012,256(3):487-493.

[9] Gonzalez-Rivas D,Fieira E,Mendez L,et al.Single-port video-assisted thoracoscopic anatomic segmentectomy and right upper lobectomy[J].Eur J Cardiothorac Surg,2012,42(6):e169-e171.

[10] Gonzalez-Rivas D,de la Torre M,Fernandez R,et al.Video: Single-incision video-assisted thoracoscopic right pneumonectomy [J].Surg Endosc,2012,26(7):2078-2079.

[11] Gonzalez-Rivas D,Fernandez R,Fieira E,et al.Uniportal video-assisted thoracoscopic bronchial sleeve lobectomy: first report [J].J Thorac Cardiovasc Surg,2013,145(6):1676-1677.

[12] Gonzalez-Rivas D,Delgado M,Fieira E,et al.Single-port video-assisted thoracoscopic lobectomy with pulmonary artery reconstruction [J].Interact Cardiovasc Thorac Surg,2013,7(5):889-891.

[13] 鲍熠,周逸鸣,杨倍,等.单孔全胸腔镜下肺叶切除术5例[J].中华胸心血管外科,2013,29(8): 493-494.

[14] 李洋,张科伟,刘伟,等.单孔电视辅助胸腔镜肺叶切除术20例[J].中华胸心血管外科,2014,30(9): 566-567.

[15] Bertolaccini L,Rocco G,Viti A,et al.Geometrical characteristics of uniportal VATS [J].J Thorac Dis,2013,5 (Suppl 3):S214-S216.

[16] Rocco G.One-port (uniportal) video-assisted thoracic surgical resections--a clear advance [J].J Thorac Cardiovasc Surg,2012,144(3):S27-S31.

[17] Tamura M,Shimizu Y,Hashizume Y.Pain following thoracoscopic surgery: retrospective analysis between single-incision and three-port video-assisted thoracoscopic surgery [J].J Cardiothorac Surg,2013,12(8):153.

单孔电视辅助胸腔镜肺切除手术的临床应用(附100例报告)

Clinical application of uniportal video-assisted thoracoscopic pulmonary resection with 100 cases report

RichHTML

PDF (PC)

赞

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 2

Metrics

本文评价

推荐阅读 0

[1]	林星宇,杨志广,张鹏,邵国光. 全胸腔镜肺叶切除与开胸肺叶切除治疗老年肺癌的疗效比较[J]. 吉林大学学报(医学版), 2014, 40(06): 1275-1279.
[2]	吴楠，石东磊，徐沛然. 两孔式胸腔镜肺叶切除术和传统三孔式胸腔镜肺叶切除术临床效果比较[J]. 吉林大学学报(医学版), 2014, 40(02): 418-421.