探讨单孔全胸腔镜手术治疗胸部疾病的安全性及可行性.docVIP

探讨单孔全胸腔镜手术治疗胸部疾病的安全性及可行性 　　摘要：目的 探讨单孔全胸腔镜手术在胸部疾病治疗中的可行性及安全性。方法 2015年3月～5月，施行全麻双腔气管插管下单孔全胸腔镜手术25例。于腋前线与腋中线间第4或第5肋间做切口长3～5 cm，置入10 mm 30°胸腔镜和器械，行肺大疱切除+胸膜固定术3例，肺楔形切除术3例，病变活检+Ⅰ125放射性粒子植入术1例，纵隔肿瘤切除术1例，肺叶切除4例，肺癌根治术13例。结果 1例增加一个辅助操作孔，1例中转开胸。手术时间为70～347min，平均191min；术中出血10～300 ml，平均89ml；胸腔闭式引流时间1～7d，平均3.6 d；术后住院2～9d，平均4.6d。全组无术后持续漏气、无肺不张、肺部感染、出血及肺栓塞等严重并发症，无围手术期死亡。结论 单孔胸腔镜手术治疗胸部各种疾病安全可行，可重复，值得推广。 　　关键词：单孔； 胸腔镜； 胸部疾病 　　To Explore the Safety and Feasibility of Single-port Complete Video-assisted for Treatment Chest Lesion 　　ZHANG Chang-hong，DU Ming，CHEN Dan，ZHONG Hua-ling 　　（Department of Thoracic and Cardiovascular Surgery，The First Affiliated Hospital，Chongqing Medical University，Chongqing 400016，China） 　　Abstract：Objective To explore the safety and feasibility of single- port complete video-assisted for treatment chest lesion. Methods A total of 25 cases of Chest lesion underwent single-port complete video- assisted thoracoscopic surgery in double lumen endotracheal intubation under general anesthesia in our hospital from March 2015 to May 2015.The incision of about 3～5 cm long was cut between the anterior axillary line and the midaxillary line in the fourth or fifth intercostal space and 10 mm 30°thoracoscope and instruments were inserted through the incision.25 patients underwent single- port cVATS procedure including procedure including：among which 3 cases of pulmonary bulla resection and pleurodesis，3 cases of wedge resection of the lung，1 cases of mediastinal tumor biopsy and Iodine125 implant surgery，1 case of mediastinal tumor excision， 4 case of lobectomy，13 case of lung cancer resection.Results 1 case of patient need converse to biportal and 1 open .The average operative time was 191 min（70～347 min）.The average blood loss was 89 ml （10～300 ml）.The average time of closed thoracic drainage was 3. 6 d （1～7d）.The average time of postoperative hospital stay was 4. 6 d （2～9 d）.No postoperative severe complications and death occurred.Conclusion The way of single-