胸腔镜辅助胸腔淋巴结清扫术

目的 探讨胸腔镜肺门和纵隔淋巴结清扫术的临床操作方法及其适应证和局限性。方法 从１９９４年１２月至１９９８年１２月，在行胸腔镜辅助肺叶切除术治疗外周型肺癌和行食管癌根治术中，同期进行肺门、纵隔淋巴结清扫术，共完成７４例。其中肺叶切除和淋巴结清扫术６１例，食管癌根治术１３例。结果 ５８例Ｉ～Ⅱａ期肺叶切除术中，切出肺叶淋巴结１９７个，肺门淋巴结１３９个，食管旁淋巴结１３９个、隆突下淋巴结１２８个、主

Lymphadenectomy by VATS

Objective To study the lymphadenectomy in the hilar and mediastinum by VATS and its indication and limitation.Methods From December 1994 to December 1998, 74 cases of lymphatomy in lobectomy (61) or esophagectomy (13) were performed by VATS.Results For the thoracic cancer in the early stage, VATS lypmhadenectomy was a satisfactory operative technique especially when the diameter of lympha nodes was less 2 cm and lyphatic nodes did not adhere to the vessels. Totally 1 316 lymph nodes including, 197 lobe nodes 139 hilar nodes , 139 esophagus nodes, 128 tracheal carina nodes, 162 aortic arch nodes , 296 tracheal nodes, 186 mediastinum nodes, and 69 lower pulmonary ligament nodes were removed. Cancer cells were found in 86 lymph nodes, accounting for 6 5%.Conclusion Lymphadenectomy can be done technically in VATS lobectomy and esophagectomy for the chest cancer except the lyphatic nodes are larger than 2 cm in diameter or adhere to the vessels.