全电视胸腔镜肺叶切除58例临床体会-第三军医大学学报.doc

全电视胸腔镜肺叶切除86例临床体会 许川 梅宏 孙勇攀 韩连奎 刘迪 贵州省人民医院胸外科（贵州 贵阳 550002） 【摘要】目的 总结全电视胸腔镜肺叶切除在治疗肺部疾病中的临床经验，探讨其适应症、手术方法、技术要点及其安全性。 方法 回顾性分析2007年11月至2013年6月应用全电视胸腔镜肺叶切除治疗肺部疾病86例，恶性肿瘤患者行系统性淋巴结清扫。 结果 86例患者中3例中转开胸，其余均在全电视胸腔镜下完成手术。 结论 全电视胸腔镜肺叶切除安全可行，更加微创，但应选择适当的病例，尤其在开展手术的早期阶段，应严格掌握手术适应证。 电视胸腔镜技术在临床上的使用越来越广泛，已经成为胸外科不可或缺的诊断和治疗手段。自1992年第一例【1】完全胸腔镜下解剖性肺叶切除以来，胸腔镜手术(video-assisted thoracoscopic surgery,VATS)发展迅猛，随着手术技术的进步和经验的积累，作为微创胸外科制高点的“全胸腔镜下肺叶切除”在治疗肺部疾病中的作用已得到公认和肯定。我科于2007年11月至2013年6月应用全电视胸腔镜肺叶切除治疗肺部疾病86例，效果满意。现总结临床经验，探讨其适应症、手术方法、技术要点及其安全性. 关键词：全电视胸腔镜手术, 肺叶切除, 临床体会 Full VATS lobectomy 86 cases of clinical experience Xu chuan meihong sun yong-pan han lian-kui liu di Guizhou Provincial Peoples Hospital of Thoracic Surgery (Guiyang 550002, China) [Abstract] Objective To summarize the whole VATS lobectomy in the treatment of lung disease in clinical experience, explore its indications, surgical methods, techniques and safety. Methods A retrospective analysis from November 2007 to June 2013 using the whole VATS lobectomy in the treatment of pulmonary disease, 86 cases of patients with systemic malignant lymph node dissection. Results 86 patients in the three cases of conversion to thoracotomy, the rest were completed in full thoracoscopic surgery. Conclusion The total VATS lobectomy is safe and feasible, more invasive, but should select the appropriate cases, especially in the early stages to carry out surgery, surgical indications should be strictly controlled. ??? VATS techniques in clinical use and more widely, thoracic surgery has become an indispensable tool in the diagnosis and treatment. Since 1992, the first case [1] completely thoracoscopic anatomic lobectomy since VATS (video-assisted thoracoscopic surgery, VATS) is developing rapidly, with advances in surgical techniques and experience, as a minimally invasive thoracic surgery commanding heights all thoracoscopic lobectomy in the treatment of lung diseases has been recognized and affirmed the role.