免内镜缝合切割器电视胸腔镜肺楔形切除术探析.docVIP

免内镜缝合切割器电视胸腔镜肺楔形切除术探析【摘要】 目的 探讨免内镜缝合切割器（Endo GIA）电视胸腔镜（VATS）肺楔形切除术的可行性和价值。方法 分析从2005年2月至2007年5月不用Endo GIA行电视胸腔镜肺楔形切除术治疗肺部外周型良性结节7例的临床资料。结果 7例均顺利完成手术，无中转开胸手术，平均手术时间72 min，术后留置胸管平均时间46 h，术后平均住院5．1 d，术后病理：肺结核瘤4例、肺错构瘤2例、肺炎性假瘤1例。出院后随访1~11个月，无复发或并发症发生。结论 不用Endo GIA电视胸腔镜肺楔形切除术是诊治肺外周型良性结节的一种安全可靠的新方法，具有创伤小、痛苦轻、恢复快及节省医疗费用等优点，适宜在我国广大不发达地区开展。? 【关键词】电视胸腔镜；肺楔形切除术；内镜缝合切割器 ?? Preliminary study of video assisted thoracopic pulmonary wedge resection without using Endo GIA (report of 7 cases) FU Yu,YING Xiu-mei,WANG Zhi-hui,et al.Qianwei Hospital,Changchun,Jilin Province 130012,China ? 【Abstract】 Objective To discuss the feasibility and value of a new procedure-video assisted thoracopic (VATS) pulmonary wedge resection without using Endo GIA.Methods From February 2005 to May 2007,7 patients whose preoperative diagnosis were peripheral benign nodes,including 4 males and 3 females,underwent VATS pulmonary wedge resection without using Endo GIA.Results All procedures were accomplished.There was no conversion to thoracotomy.The average of operation time was 72 min.The average of duration of thoracic drainage time was 46 hours.Mean postoperative hospitalizion was 5．1 days.Pathologic diagnosis were as follows: tuberculosis for 4,hamartoma for 2 and inflammatory pseudotumor for 1．There were no incidence of postoperative complication and mortality.Conclusion The result of this study suggests that video assted thoracopic pulmonary wedge resection without using Endo GIA is acceptable approach in the diagnosis and treatment of peripheral benign nodes.? 【Key words】VATS; Pulmonary wedge resection; Endo GIA 本院2005年2月至2007年5月不用Endo GIA行电视胸腔镜肺楔形切除术治疗的肺部外周型良性结节7例，术中以大心耳钳夹住病灶边缘肺组织，用电剥离钩切除病灶，间断结节缝合肺断面，术中行快速病理以排除恶性肿瘤。手术均获成功，无开胸手术或辅助小切口手术，无并发症发生，术后病理诊断为肺结核瘤4例，肺错构瘤2例，肺炎性假瘤1例。现报告如下。? 1 资料和方法? 1．1 一般资料 患者共7例，男4例，女3例。年龄20~52岁，平均36岁。其中5例无症状及明显阳性体征，体检行胸片及CT发现肺部肿物；2例有肺结核病史，经系统抗结核治疗后复查胸片及CT提示肺结核瘤可能性大。所有病例均行胸部正、侧位X线片及胸部CT检查，均为孤立的球形块影，其中右肺上叶后段2例，右肺下叶背段1例，左肺上叶尖段1例，左肺上叶后段2例，左肺下叶背段1例，肺部块影