电视辅助胸腔镜手术在小儿支气管源性囊肿外科治疗上的应用

目的 探讨电视辅助胸腔镜手术(VATS)在小儿支气管源性肺囊肿治疗中的作用.方法 回顾性分析笔者两院1993年6月至2007年6月经VATS切除并病理证实的41例小儿支气管源性肺囊肿患儿的临床资料.麻醉方式全部采取单腔管插管吸入全麻,手术采取胸腔镜进行,必要辅助小切口协助将病灶以及肺组织取出;气管残端采取间断缝合或者Endo-cutter钉合,统计分析手术时间、切口大小、术后引流时间及总量、术后住院时间.结果 患儿均经VATS手术治疗.年龄从8d～12岁,平均为4.81岁.2例纵隔型支气管囊肿行VATS纵隔囊肿切开+翻转术,14例肺内型行肺楔形切除术,25例肺内单发性囊肿或局限于肺段的多发性肺囊肿行肺叶切除术.全组手术时间为45～265min,平均71.5 min;切口为1.5～7.0 cm.平均4.4 cm;术中失血5～400ml,平均41.5 ml;术后均放置胸管1～2条,引流1～7 d,平均2.0 d;总引流量1 5～770 ml,平均207.2 mt;平均术后住院时间为1～25 d,平均7.0 d.结论 VATS的d,JL支气管源性肺囊肿治疗是可行、安全、彻底、微创的,可成为标准术式.

The use of video-assisted thoracic surgery in the treatment of pediatric bronchogenic pulmonary cysts

Objective To study the role of video-assisted thoracic surgery(VATS)in the treatment of pediatric bronchogenie pulmonary cyst.Methods We had performed a retrospective review included 41 patients undergoing pediatric bronchogenic pulmonary cyst treatment by VATS at our department between Junl993 and Jun 2007.Patients aged from 8 days to 12 years with an average of 4.81years.All of the patients were performed single-lumen end otracheal tube anesthesia.Two-port VAT Swas aDplied,and other 1 or 2 ports might be replenished if it was necessary.Other small incision was necessity to remove tissue and bronchogenic pulmonary cyst foci.Simple interrupted suture or Endo-cutter was performed to close bronchial stump.The clinical records of all patients were recorded for anatysis:incision size,duration of surgery,type of surgery,drain quantity,time of chest tube drainageand Postoperative stay.Results All of the patients underwent VATS.Two cases with mediastinal bronchogenic cyst underwent cyst incision and turnover operation,14 cases with intrapulmonary cyst underwent pulmonary wedge resection,and 25 cases with single or multiple pulmonary cysts confined to one lobe underwent lobectomy.Operation time varied from 45 to 265 min with an average of41.45 min.Incision length varied from 1.5 to 7 cm(average,4.41 cm).Intraoperative bleeding volumevaried from 5 to 400 ml(average,41.45 m1).One or two tubes of chest drainage were preserved for 1to 7 days(average 2.02 d).Whole drainage volume varied from 85 to 770 ml(average,207.17 ml).Postoperative hospital stay varied from 1 to 25 d(average,6.97 d).Conclusions VATS is a feasible,safe,and minimal invasive treatment to pediatric bronchogenic pulmonary cysts.