单操作孔电视胸腔镜手术治疗胸部疾病-第三军医大学学报.DOCVIP

276例单操作孔全胸腔镜肺叶切除治疗早期非小细胞肺癌的围手术期结果分析 谭群友，邓 波，康珀铭，周景海，何 勇，王如文，蒋耀光（400042重庆，第三军医大学大坪医院野战外科研究所全军胸外科研究所） [摘要]目的 探讨单操作孔完全电视胸腔镜肺叶切除术（single utility port video-assisted thoracoscopic surgery， SP-VATS）治疗早期非小细胞肺癌的围手术期结果。方法 2007年3月至2011年12月，采用SP-VATS技术治疗早期非小细胞肺癌276例男163例，女113例；年龄32～73（54.1±16.6）岁。除胸腔镜孔以外，仅采用一个长约3～5 cm小切口为操作孔完成。结果 全组无围手术期死亡7例（2.5%）中转为开胸手术时间68～159 （138.6±41.7）min；术中出血10～305（127.2±36.4）ml无术中输血淋巴结清扫9～35（13.5±3.8）枚。术后并发症：肺不张6例，肺漏气（＞7d）1例，各种心律失常4例。术后日内胸腔引流液总量482～1501 ml，平均（705.8±137.9）ml。术后无明显肩背部疼痛与感觉异常。结论 SP-VATS肺叶切除术微创、安全，淋巴结清扫彻底，并发症少，于治疗早期非小细胞肺癌。 [关键词] 电视胸腔镜手术；单操作孔；肺叶切除；非小细胞肺癌 [中图法分类号] R734.2 [文献标识码] A Perioperative outcomes of complete video-assisted thoracoscopic lobectomy for early-stage non-small cell lung cancersingle utility port Tan Qunyou，Deng BO，Kang Poming，Zhou Jinghai，He Yong，Wang Ruwen，Jiang Yaoguang Department of Thoracic Surgery，Institute of Surgery Research，Daping Hospital，Third Military Medical University，Chongqing，400042，China [Abstract] Objective We aimed to explore the perioperative clinical outcomes of lobectomy by single utility port video-assisted thoracoscopic surgery (SP-VATS) for early-stage non-small cell lung cancer. Methods From March 2007 to December 2011， 276 cases with early-stage non-small cell lung cancer in Daping Hospital received thoracoscopic lobectomy via single utility port. In additional to an incision for thoracoscope，only one single utility port an incision ranged from 3.5cm to 5cm) was used for lobectomy and lymphonectomy. We evaluated the clinical outcomes including operative time，intraoperative blood loss，dissected lymph node number and postoperative complications. Results There was no perioperative death. Seven cases were conversed to thoracotomy2.5%) during SP-VATS. Operative time ranged from 68 to159 (138.6±41.7) min and intraoperative blood loss from 10 to 305 (127.2±36.4) ml. The number of removed lymph nodes ranged from 9 to 35 (13.5±3.8) per case. Postoperative complications included six cases wit