目的?探討單操作孔電視胸腔鏡手術(single-port VATS) 治療肺部疾病的手術操作方法和臨床應用價值。?方法?2008 年1 月至2010 年6月四川大學華西醫(yī)院胸外科采用單操作孔電視胸腔鏡手術治療肺部疾病158例。病種包括:氣胸67例、肺良性結節(jié)(炎性假瘤、錯構瘤和硬化性血管瘤)39例、結核球44例、肺癌8例。70例術前明確診斷,其余均經術中冰凍及術后病理診斷確診。切口均為1個操作孔和一個觀察孔,術后均采用單根28號引流管。手術行病變局部切除151例,單肺葉切除7例;同期雙側手術6例。?結果?局部切除患者平均手術時間18 (5~60) min,平均出血量33 (5~95) ml,無術中輸血;術中增加切口10例,其中6例為胸膜腔閉鎖或粘連嚴重,4例術中出血;術后平均住院時間2.5 (2~4) d,平均住院費用17 884(15 476~25 387)元。單肺葉切除(包括淋巴結清掃)患者平均手術時間128 (50~220) min,平均出血量180 (80~478) ml,術中未輸血;術中增加切口1例;平均住院費用42 385 (38 965~57 695)元,平均術后住院時間4.7 (4~7)d。全組患者無圍手術期死亡和重大并發(fā)癥。?結論 單操作孔電視胸腔鏡手術治療肺部疾病安全、可靠,可作為適合患者的手術方式。
引用本文: 車國衛(wèi),梅龍勇,梅建東等. 單操作孔電視胸腔鏡手術治療肺部疾病158例臨床分析. 中國胸心血管外科臨床雜志, 2012, 19(2): 116-119. doi: 復制
版權信息: ?四川大學華西醫(yī)院華西期刊社《中國胸心血管外科臨床雜志》版權所有,未經授權不得轉載、改編
1. | 劉倫旭, 車國衛(wèi), 王允, 等. 電視胸腔鏡手術治療肺良性疾病128例. 中國胸心血管外科臨床雜志, 2008, 15(1):29-31. |
2. | Salati M, Brunelli A, Xiumè F, et al. Uniportal video-assisted thoracic surgery for primary spontaneous pneumothorax: clinical and economic analysis in comparison to the traditional approach. Interact Cardiovasc Thorac Surg, 2008, 7(1):63-66. |
3. | Gonzalez-Rivas D, dela Torre M, Fernandez R, et al. Single-port video-assisted thoracoscopic left upper lobectomy. Interact Cardiovasc Thorac Surg, 2011, 13(5):539-541. |
4. | Gonzalez D, Paradela M, Garcia J, et al. Single-port video-assisted thoracoscopic lobectomy. Interact Cardiovasc Thorac Surg, 2011, 12(3):514-515. |
5. | Liu L, Che G, Pu Q, et al. A new concept of endoscopic lung cancer resection: Single-direction thoracoscopic lobectomy. Surg Oncol, 2010, 19(2):71-77. |
6. | 車國衛(wèi), 劉倫旭.肺癌微創(chuàng)治療進展. 癌癥進展, 2011, 9(6):605-609. |
7. | Sihoe AD, Au SS, Cheung ML, et al. Incidence of chest wall paresthesia after video-assisted thoracic surgery for primary spontaneous pneumothorax. Eur J Cardiothorac Surg, 2004, 25(6):1054-1058. |
- 1. 劉倫旭, 車國衛(wèi), 王允, 等. 電視胸腔鏡手術治療肺良性疾病128例. 中國胸心血管外科臨床雜志, 2008, 15(1):29-31.
- 2. Salati M, Brunelli A, Xiumè F, et al. Uniportal video-assisted thoracic surgery for primary spontaneous pneumothorax: clinical and economic analysis in comparison to the traditional approach. Interact Cardiovasc Thorac Surg, 2008, 7(1):63-66.
- 3. Gonzalez-Rivas D, dela Torre M, Fernandez R, et al. Single-port video-assisted thoracoscopic left upper lobectomy. Interact Cardiovasc Thorac Surg, 2011, 13(5):539-541.
- 4. Gonzalez D, Paradela M, Garcia J, et al. Single-port video-assisted thoracoscopic lobectomy. Interact Cardiovasc Thorac Surg, 2011, 12(3):514-515.
- 5. Liu L, Che G, Pu Q, et al. A new concept of endoscopic lung cancer resection: Single-direction thoracoscopic lobectomy. Surg Oncol, 2010, 19(2):71-77.
- 6. 車國衛(wèi), 劉倫旭.肺癌微創(chuàng)治療進展. 癌癥進展, 2011, 9(6):605-609.
- 7. Sihoe AD, Au SS, Cheung ML, et al. Incidence of chest wall paresthesia after video-assisted thoracic surgery for primary spontaneous pneumothorax. Eur J Cardiothorac Surg, 2004, 25(6):1054-1058.