252例电视胸腔镜手术回顾性分析

目的探讨预防电视胸腔手术（VATS）并发症的方法及电视胸腔镜手术在胸外科领域的应用前景。方法回顾分析1997年6月-2006年2月252例行VATS手术患者的临床资料，术式包括肺大疱切除122例，纵隔肿瘤切除4例，食管肿瘤切除12例，肺叶切除或楔形切除65例，胸外伤止血和／或肺叶修补术18例，胸膜疾病活检术8例，手汗症双侧颈胸交神经节切除23例。结果252例VATS手术顺利，3例自发性气胸术后复发，4例术后持续漏气，手术并发症发生率2．8％（7／252）。结论VATS比传统胸外科手术具有诸多无法比拟的优点．在胸心外科有广阔的应用空间．但一次性耗材价格昂贵，限制其临床广泛应用。

Use of video assisted thoracoscopy in management of chest diseases

Objective] To study the indications and techniques of video assisted thoracoscopic surgery(VATS)in treatment of thoracical diseases.Methods] 252 patients underwent traditional three trocars or assisted mini-incision VATS for spontaneous pneumothorax(122),chest trauma(18),pulmonary diseases(65),pleural disease(8),mediastinal tumor(4),esophageal tumor(12),and palmar hyperhidrosis(23)from June 1997 to February 2006.Results] Complications occured in 7(2.8%),three spontaneous pneamothorax reoccured postoperatively,four patients occurred persistent air leak(over 8 days)postoperatively.Conclusion] VATS is a new skill of thoracic surgery,more attentions must be paid to prevent and reduce complication,and reduce the fee in order to generalize the use of it.