胸腔镜下局部中央型肺癌术前心包探查的应用探讨

 目的　探讨胸腔镜下中央型肺癌心包探查的安全和可靠性，评价其手术的应用价值。方法　2008年6月至2011年12月，对41例中心型肺癌患者，实施术前电视辅助胸腔镜心包探查术。结果　胸腔镜心包探查后行肺切除术并心包内处理肺动脉8例（合并心包部分切除2例）、肺静脉10例，心包外全肺切除术9 例；螺旋CT手术预测符合率仅为65.8 %，平均心包探查（23±10）min。结论　胸腔镜技术除可广泛应用于肺楔形切除、肺叶切除等手术方式外，为提高中晚期局部中央型肺癌手术切除率和生存率，电视辅助胸腔镜心包探查可减少剖胸探查术的必要。

Application of preoperative thoracoscopic pericardial exploration in local central lung cancer

Objective　To discuss the security and reliability of preoperative thoracoscopic pericardial exploratory and to evaluate of the surgical indications. Methods　Ｖideo full-assisted thoracoscopic pericardioscopy has been implemented in 41 central type lung cancer cases before radical resection. Results　Video assisted pericardioscopy group underwent thoracotomy lung resection with procession of intrapericardial pulmonary artery in 8 cases (partial pericardial resection in 2 cases), with pulmonary vein in 10 cases, and out-pericardial lung resection in 9 cases. Spiral CT projections were consistent with surgery was only 65.8 %. The average time of explorationa was (23±10) min. Conclusion　Except for widely used in pulmonary wedge resection and lobectomy, video-assisted thoracoscopic pericardial exploration can improve resection rate and survival rate in central type lung cancer patients which can reduce the need for exploratory thoracotomy.