单操作孔全胸腔镜手术治疗原发性肺癌

目的探讨单操作孔胸腔镜（Video-Assisted Thoracoscopic Surgery, VATS）手术治疗原发性肺癌的临床意义。方法2009年9月-2010年3月我科开展单操作孔VATS治疗原发性肺癌29例，所有患者均行解剖性肺叶切除并纵隔淋巴结清扫。结果29例中右肺上叶切除11例，右肺中叶切除5例，右肺下叶切除7例，左肺上叶切除1例，左肺下叶切除5例。全部患者手术过程顺利，平均手术时间（150．7±36．8）min，平均每例清除淋巴结12．6枚。TNM分期：Ⅰa期13例、Ⅰb期9例、Ⅱa期2例、Ⅱb期1例、Ⅲa期4例。全部患者术后恢复顺利，无肺部感染、严重心律失常、二次开胸止血等并发症，无围手术期死亡。结论单操作孔VATS治疗原发『生肺癌是可行的，能完成系统性纵隔淋巴结清扫，具有创伤小、恢复快的优点。

Single utility port complete thoracoscopic surgery for primary lung cancer

Objective To study clinical value of uniportal video-assisted thoracoscopic surgery（VATS） for primary lung cancer. Methods VATS was performed for primary lung cancer in 29 patients with lobectomy and dissection of systematic mediastinal lymph nodes from September 2009 to March 2010 in our department. Results Of the 29 patients, 11 underwent right upper lobectomy, 5 right middle lobectomy, 7 right lower lobectomy, 1 left upper lobectomy, 5 left lower lobectomy. The procedure was successful in all patients with no patient transferred for thoracotomy. The mean operative time was 150.7 ± 36.8min, the average number of dissected lymph nodes from each patient was 12.6. The lung cancer was classified as TNM stage Ⅰa, Ⅰb, Ⅱa, Ⅱb, and Ⅲa in 13, 9, 2, 1, and 4 patients, respectively, accounting for 44.8%, 31.0%, 6.9%, 3.4%, and 13.8% of the total patients, respectively. All patients recovered uneventfully with no severe complications such as pulmonary infection, arrhythmia, and bleeding. No postoperative death occurred. Conclusion Uniportal VATS is technically feasible for lung cancer and can complete lobectomy and dissection of systematic mediastinal lymph nodes with the advantages of minimal invasiveness and rapid postoperative recovery.