右侧电视胸腔镜经后纵隔同期治疗双侧肺大疱

目的 探讨电视胸腔镜手术(VATS)右侧进胸,经后纵隔顶部入左胸腔,同期治疗双侧肺大疱的可行性及疗效.方法 2007年10月至2009年6月共为15例自发性气胸双侧肺尖大疱患者施行同期双侧肺大疱切除术.结果 15例患者均顺利完成手术,手术时间80～140 min,术中出血平均45 ml,术后无并发症,平均住院7 d,全部患者随访4～20个月,无死亡和复发.结论 右侧胸腔镜经后纵隔同期治疗肺大疱技术上可行,近期创伤小,疗效较好.

The right-sided video-assisted thoracic surgery apico-posterior transmediastinal approach for bilateral bullectomy in singal-stage

Objective To evaluate the feasibility, efficacy of the right-sided video-assisted thoracic surgery (VATS) apico-posterior transmediastinal approach for large blebs at the apes of both lungs in single-stage. Methods From October 2007 to June 2009, Singal-stage the right-sided VATS apico-posterior transmediastinal approach was carried out in 15 cases of primary spontaneous pneumothorax, treated by bilateral bullectomy. Results All the patients were treated successfully, the operating times ranged from 80 to 140 minutes. The average intra operative blood loss was 45 ml. The average of hospital stay was 7days. The duration of follow-up was 4 to 20 months, no death, and no recurrence. Conclusions Single-stage right-sided VATS, apico-posterior transmediastinal approach for bilateral bullectomy is a minimally invasive, effective and reliable method. Modification of the original technique of procedure and evaluation of long-term result require further study.