单孔胸腔镜治疗胸部良性病变18例

目的探讨单孔胸腔镜手术在胸部良性病变治疗中的可行性及安全性。方法2012年10月～2013年8月，施行全麻双腔气管插管下单孔胸腔镜手术18例。于腋前线与腋中线间第4或第5肋间做切口长2～3cm，置入5mm 30°胸腔镜和器械，行肺大疱切除、胸膜固定术12例，胸腔止血、肺大疱切除、胸膜固定术1例，肺楔形切除术3例，胸腺囊肿切除术1例，纵隔肿瘤切除术1例。结果无中转开胸或增加辅助切口。自发性气胸12例，自发性血气胸1例，肺结核球3例，胸腺囊肿1例，纵隔神经鞘瘤1例。手术时间30～82min，平均55min，出血量10～100ml，平均50ml。胸腔闭式引流时间2～5d，平均3．5d。术后随访2～12个月，平均5．2月，无复发及其他并发症。结论单孔胸腔镜手术治疗胸部良性病变简单易行，安全可靠。

Single-site Video-assisted Thoracoscopic Surgery for 18 Cases of Benign Thoracic Lesion

Objective To explore the feasibility and safety of single-site video-assisted thoracoscopic surgery for benign thoracic lesion. Methods A total of 18 cases of benign thoracic lesion underwent single-site video-assisted thoracoscopic surgery in double lumen endotracheal intubation under general anesthesia in our hospital from October 2012 to August 2013. The incision of about 2 -3 cm long was cut between the anterior axillary line and the midaxillary line in the fourth or fifth intercostal space and 5 mm 30° thoracoscope and instruments were inserted through the incision. There were altogether 12 cases of pulmonary bulla resection and pleurodesis, 1 case of thoracic hemostasis, pulmonary bulla resection and pleurodesis, 3 cases of wedge resection of the lung, 1 case of thymic cyst excision and 1 case of mediastinal tumor excision. Results There was no conversion to thoracotomy or additional assisted incision. There were altogether 12 cases of spontaneous pneumothorax, 1 case of spontaneous hemopneumothorax, 3 cases of pulmonary tuberculoma, l case of thymic cyst and 1 case of neurilemmoma of mediastinum. The average operative time was 55 min （ 30 - 82 min）. The average blood loss was 50 ml （ 10 - 100 ml）. The average time of closed thoracic drainage was 3.5 d （2 - 5 d）. The average postoperative follow-up was 5. 2 months （2 - 12 months ） and no relapse or other complications was found. Conclusion Treatment of benign thoracic lesion with single-site video-assisted thoracoseopic surgery is simple, safe and reliable.