单操作孔胸腔镜下肺外周性病变的手术治疗

目的探讨单操作孔胸腔镜下手术治疗肺外周性病变的可行性。方法回顾分析54例肺外周性病变的临床资料,所有患者均采用胸腔镜手术治疗。胸腔镜观察孔取腋中线第7肋间,切口约1.5cm,操作孔取腋前线第4或5肋间,切口长约2～3cm,经单一操作孔完成胸腔内手术操作。结果 54例患者中（肺大疱和自发性气胸38例,肺外周孤立性结节或包块16例）单操作孔手术52例,传统三孔手术2例;手术时间20～110min,平均43min;术中出血10～300ml,平均70ml。术后患者均顺利恢复,未出现严重并发症。结论单操作孔电视胸腔镜手术进一步降低了创伤,可以完成肺外周性病变的手术治疗,安全可行,应作为肺外周性病变的主要治疗术式。

Uniportal video-assisted thoracic surgery for pulmonary peripheral lesions

Objective To discuss the clinical feasibility of uniportal video-assisted thoracic surgery（VATS） for treatment of pulmonary peripheral lesions.Methods To review and analyze 54 pulmonary peripheral lesion cases that all underwent VATS operations.the incision for observation was 1.5cm at lateral position of the seventh rib of middle axillaryline,The incision for operation was 1.5～4.0cm at lateral position of the fourth or fifth rib of anterior axillary line.The operations were performed through the single incision.Results Of the 54 patients（38 patients with spontaneous pneumothorax or pulmonary bleb and 16 patients with solitary pulmonary nodules）,52 patients underwent uniportal VATS while 2 patients were operated with conventional three-port VATS.Operative time was 20～110 min,an average of 43min.Intraoperative blood loss 10～300 ml,an average of 70ml.All patients recovered smoothly without severe complications.Conclusion Uniportal VATS appears to be tolerable,safe and efficient in treating pulmonary peripheral lesions with minimal invasive and should be accepted as the alternative treatment.