单操作孔全胸腔镜在胸部疾病诊断与治疗中的应用

目的:探讨单操作孔全胸腔镜在胸部疾病的诊断与治疗中应用的可行性及临床价值。方法:采用单操作孔全胸腔镜行胸部疾病诊断和治疗337例,其中自发性气胸84例,创伤性血气胸9例,胸膜疾病10例,乳糜胸3例,肺良性肿瘤73例,肺转移瘤4例,肺隔离症1例,肺癌39例,支气管扩张5例,肺炎性假瘤13例,肺结核瘤46例,肺囊肿4例,纵隔肿瘤43例,食管平滑肌瘤3例。结果:本组333例患者手术过程顺利,4例中转辅助小切口开胸完成手术。平均手术时间(67.8±19.8)min,术中出血(88.6±47.2)ml;胸腔引流管拔出时间(2.4±1.1)d;术后住院时间(4.4±3.0)d。4例肺不张,5例肺部感染,4例出血等并发症,其中1例肺部感染并发呼吸衰竭术后12 d死亡,余患者术后恢复顺利。结论:单操作孔全胸腔镜行胸部疾病的诊断和治疗在技术上是安全、可行的,具有创伤小、恢复快等优点。

Diagnosis and treatment of thoracic disease by single-port complete video-assisted thoracoscopic surgery

Objective：To investigate the feasibility and clinical value of single-port complete video-assisted thoracoscopic surgery（VATS） in the diagnosis and treatment of thoracic disease.Methods： From January 2010 to January 2012,the single-port complete VATS was performed in 337 patients,including spontaneous pneumothorax in 84,traumatic hemopneumothorax in 9,pleura disease in 10,chylothorax in 3,pulmonary benign tumor in 73,pulmonary metastasis in 4,pulmonary sequestration in 1,lung carcinoma in 39,bronchiectasis in 5,pulmonary inflammatory pseudotumor in 13,pulmonary tuberculoma in 46,lung cyst in 4,mediastinal tumor in 43,and leiomyoma of esophagus in 3.Results：The operations were completed successfully in 333 patients,and the other 4 patients were turned to mini-incision thoracotomy.The operative time was（67.8±19.8） min,the intraoperative blood loss was（88.6±47.2） ml,the draining time of intrathoracic drain tube was（2.4±1.1） d,and the postoperative length of stay was（4.4±3.0） d.Conclusion：The single-port complete VATS is safe and feasible for the diagnosis and treatment of thoracic disease,with merits of minimal invasion and quick recovery.