电视胸腔镜辅助下小切口肺切除术

目的总结电视胸腔镜辅助下小切口肺切除术的方法.方法2002年1月至2004年12月我们对56例肺部包块患者进行了电视胸腔镜辅助下肺切除手术治疗,对患者的临床资料进行回顾性分析.本组患者包括肺楔形切除18例,肺叶切除23例,全肺切除15例;中转开胸手术2例.结果全组手术患者均安全度过围手术期,无手术死亡病例,与常规开胸手术比较,具有创伤小、术后恢复快的优点.结论电视胸腔镜下小切口肺切除术有其严格的手术指征,还不能完全替代常规开胸手术,但只要指征明确,手术操作得当,在胸外科的常规手术中优势明显.

Pneumonectomy through mini-incision by video assisted thoracoscopy surgery

Objective To summarize the experience in performing pneumonectomy through mini-incision by video assisted thoracoscopy surgery. Methods A series of patients underwent VATS pneumonectomy at our hospital from Jan 2002 to Dec 2004. The factors that influence the survival of VATS patients and their backgrounds were identified. A thoracoscopic curative approach was applied in 56 patients (18 wedge resection, 23 lobectomy, 15 pneumonectomy). All patients who suffered from non-small cell lung cancer (NSCLC) were subject to lobectomy or pneumonectomy, including dissection of hilar and mediastinal lymph nodes. Results There was no death in the perioperative period. Video assisted thoracic surgery techniques led to decreased recovery time and fewer perioperative complications. It was associated with decreased perioperative pain and opiate requirement, and better postoperative pulmonary function. Conclusion Major VATS pulmonary resection with lobectomy and pneumonectomy can be performed for early malignant disease without compromising established surgical principles. VATS has obvious superiority as compared to thoracotomy, but cannot be a substitute of thoracotomy.