电视胸腔镜在孤立性肺结节诊断治疗中的价值.docVIP

精品论文 参考文献 电视胸腔镜在孤立性肺结节诊断治疗中的价值 李仁喜 夏艳武 周锋平（湘南学院附属医院胸外科 湖南郴州 423000） 【中图分类号】R655【文献标识码】A【文章编号】1672-5085（2012）5-0015-02 【摘要】目的 探讨电视胸腔镜手术（VATS）在不明性质的孤立性肺结节诊断和治疗中的价值。方法 采用VATS对36例不明性质的孤立性肺结节进行结节切除并术中快速冰冻活检，根据病检结果：恶性病变按恶性肿瘤原则进一步手术，良性病变则结束手术。手术方式：以VATS行肺楔形切除或肿物剥出并术中快速病理检查，若回报为恶性病变则在VATS下行肺叶切除加纵隔淋巴结清扫术 或辅助小切口下行肺癌根治术。结果 肺楔形切除17例，肺叶切除8例，肺叶切除加淋巴结清扫11例，无手术死亡病例。平均术后住院6.3天。术后病理：肺良性病变23例(包括结核球5例；炎性假瘤8例，错构瘤2例，曲霉球菌3例、结节纤维化2例、硬化性血管瘤2例、肺囊肿1例)。肺恶性病变13例(包括肺腺癌6例，鳞癌3例，未分化小细胞癌1例、透明细胞癌1例，肺转移性肿瘤2例)。结论 胸腔镜辅助、术中快速冰冻病理指导下的胸腔镜手术在肺不明性质的孤立性结节中的诊断和治疗具有重要价值，可显著提高肺部恶性肿瘤的诊断率，有助于肺癌的早期诊治。 【关键词】电视胸腔镜　孤立性结节　术中病理 THE DIAGNOSE AND TREATMENT VALUE OF THE TELEVISION THORACOSCOPE ON SOLITARY PULMONARY NODULE 【Abstract】Purpose: Probe the diagnose and treatment value of the video-assisted thoracoscopic surgery on the unknown qualitative solitary pulmonary nodule. Methods: Apply VATS for 36 examples of the unknown qualitative solitary pulmonary nodul to carry out eminectomy，and make the frozen biopsy quickly intraoperatively. According to the result of the frozen biopsy,the malignant diseases were moved forward a single step operation，and the benign lesion had no operation. modus operandi: wedge resection of lung or Mediastinal Lymph Node Dissection through the VATS，and made the frozen biopsy quickly intraoperatively. If the reports were malignant diseases，made the wedge resection of lung and mediastinal lymph node d issection,or the radical operation through the assistant small incision. Result: wedge resection of lung 17examples，pulmonary lobectomy 8 examples，pulmonary lobectomy and lymphaden scavenge 11 examples，no death clinical history. Be in hospital average 6.3 days after the operation. postoperative pathology: Benign lesion 23 examples(includeing tuberculoma 5 examples、inflammatory pseudotumor 8 examples、hamartoma 2 examples、aspergillus coccus 8 examples、nubble fibration 2 examples,sclerosing angioma 2 examples、lung cyst 1 examples) . Malignant disease 13 examples(includeing adenocarcinoma 6 examp