单操作孔电视胸腔镜下纵隔肿瘤切除术55例报告.docVIP

单操作孔电视胸腔镜下纵隔肿瘤切除术55例报告 桑宏阳 成少飞 李谦平 上海交通大学附属第六人民医院东院心胸外科 X 关注成功！ 加关注后您将方便地在 我的关注中得到本文献的被引频次变化的通知！ 新浪微博 腾讯微博 人人网 开心网 豆瓣网 网易微博 摘????要： 目的 探讨单操作孔电视胸腔镜手术 (video-assisted thoracoscopic surgery, VATS) 在纵隔肿瘤切除术的临床应用价值。方法 2013年12月2016年6月采用单操作孔胸腔镜手术治疗55例纵隔肿瘤, 腋中线第7肋间置入胸腔镜作为观察孔, 在腋中线与腋前线之间第4肋间做一个长34 cm横行切口作为操作孔, 经此操作孔完成手术, 术后观察孔置入胸腔闭式引流管。结果 单操作孔VATS 50例, 3例因瘤体较大, 加用辅助小切口完成手术, 2例因分离肺动脉分支时发生出血, 在腔镜下无法完成止血而中转开胸。50例单操作孔VATS手术时间 (100±46) min, 术中出血量 (85±38) ml, 术后胸管引流量 (450±80) ml, 术后胸引管拔出时间 (3.0±1.6) d, 术后住院时间 (6.2±1.5) d。术后肌无力危象1例, 气胸2例, 胸腔积液3例, 均对症处理后好转。55例术后随访224个月, (11.2±7.3) 月, 无肿瘤复发。结论 单操作孔电视胸腔镜下纵隔肿瘤切除术安全、有效, 切口美观, 值得在临床上推广。 关键词： 单操作孔; 电视胸腔镜手术; 纵隔肿瘤; 作者简介：成少飞, E-mail:shaofeicheng@126.com 收稿日期：2016-08-27 Single Utility Port Video-assisted Thoracoscopic Resection of Mediastinal Tumor:Report of 55 Cases Sang Hongyang Cheng Shaofei Li Qianping Department of Cardiothoracic Surgery, Shanghai Jiao Tong University Affiliated Sixth Peoples Hospital East Campus; Abstract： Objective To explore the clinical value of single utility port video-assisted thoracoscopic surgery (VATS) for mediastinal tumor. Methods A retrospective analysis was performed on clinical data of 55 patients with mediastinal tumor who received surgical treatment with single utility port video-assisted thoracoscopic surgery in this department from December 2013 to June2016. Routinely, the surgery was conducted by intraoperatively inserting the thoracoscope via an incision at the seventh intercostals space on the midaxillary line as the observation hole, and making a 3-4 cm transverse incision at the fourth intercostals space between the midaxillary line and the anterior axillary line as the operation hole. Postoperatively, the observation hole served as the passage for closed thoracic drainage tube. Results Among the 55 patients, 50 received total thoracoscopic surgery. In 3 cases with relatively large tumor, the surgery was conducted with additional assisted small incisions. Thoracotomy was carried ou