• 四川大學(xué)華西醫(yī)院?胸外科, 成都?610041;

目的?探討單操作孔電視胸腔鏡手術(shù)(single-port VATS) 治療肺部疾病的手術(shù)操作方法和臨床應(yīng)用價(jià)值。?方法?2008 年1 月至2010 年6月四川大學(xué)華西醫(yī)院胸外科采用單操作孔電視胸腔鏡手術(shù)治療肺部疾病158例。病種包括:氣胸67例、肺良性結(jié)節(jié)(炎性假瘤、錯(cuò)構(gòu)瘤和硬化性血管瘤)39例、結(jié)核球44例、肺癌8例。70例術(shù)前明確診斷,其余均經(jīng)術(shù)中冰凍及術(shù)后病理診斷確診。切口均為1個(gè)操作孔和一個(gè)觀察孔,術(shù)后均采用單根28號(hào)引流管。手術(shù)行病變局部切除151例,單肺葉切除7例;同期雙側(cè)手術(shù)6例。?結(jié)果?局部切除患者平均手術(shù)時(shí)間18 (5~60) min,平均出血量33 (5~95) ml,無術(shù)中輸血;術(shù)中增加切口10例,其中6例為胸膜腔閉鎖或粘連嚴(yán)重,4例術(shù)中出血;術(shù)后平均住院時(shí)間2.5 (2~4) d,平均住院費(fèi)用17 884(15 476~25 387)元。單肺葉切除(包括淋巴結(jié)清掃)患者平均手術(shù)時(shí)間128 (50~220) min,平均出血量180 (80~478) ml,術(shù)中未輸血;術(shù)中增加切口1例;平均住院費(fèi)用42 385 (38 965~57 695)元,平均術(shù)后住院時(shí)間4.7 (4~7)d。全組患者無圍手術(shù)期死亡和重大并發(fā)癥。?結(jié)論 單操作孔電視胸腔鏡手術(shù)治療肺部疾病安全、可靠,可作為適合患者的手術(shù)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(shù)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(fù)制

1.  劉倫旭, 車國衛(wèi), 王允, 等. 電視胸腔鏡手術(shù)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(jìn)展. 癌癥進(jìn)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. 1.  劉倫旭, 車國衛(wèi), 王允, 等. 電視胸腔鏡手術(shù)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. 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. 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. 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. 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. 6.  車國衛(wèi), 劉倫旭.肺癌微創(chuàng)治療進(jìn)展. 癌癥進(jìn)展, 2011, 9(6):605-609.
  7. 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.