胸腔镜隐蔽切口手术11例

目的总结11例胸腔镜隐蔽切口手术的治疗经验,探讨胸腔镜隐蔽切口手术的可行性和安全性。方法回顾性分析2011年9～11月四川大学华西医院11例行隐蔽切口胸腔镜手术患者的临床资料,其中男2例,女9例;年龄34.0(16～59)岁。术前临床诊断重症肌无力4例,胸腺瘤4例,胸腺囊肿2例,手汗症1例。胸腔镜胸腺扩大切除(extended thoracoscopic thymectomy,ETT)10例,胸腔镜交感神经干切断(endoscopic thoracic sympathectomy,ETS)1例。结果全组患者均顺利完成胸腔镜手术,无术中、术后并发症发生。手术时间70.5(30～105)min,术中出血量均<5 ml,术后胸腔引流管留置时间均<48 h,胸腔引流量55.5(30～80)ml,术后住院时间3.5(2～4)d,切口创伤小、隐蔽而美观。10例行ETT患者术后病理诊断胸腺增生4例,胸腺瘤4例,胸腺囊肿2例。结论隐蔽切口胸腔镜手术安全可行,可满足患者对切口隐蔽美观的要求。

Concealing Incision Video-assisted Thoracoscopic Surgery for 11 Patients

Objective To explore the feasibility and safety of concealing incision video-assisted thoracoscopic surgery(VATS).Methods We retrospectively analyzed the clinical data of 11 patients who underwent concealing incision VATS in West China Hospital of Sichuan University between September and November 2011.There were 2 male patients and 9 female patients with their mean age of 34.0 years(ranging from 16 to 59 years).There were 4 patients with myasthenia gravis,4 patients with thymoma,2 patients with thymus cyst,and 1 patient with hyperhidrosis.Extended thoracoscopic thymectomy was performed in 10 patients,and endoscopic thoracic sympathectomy was performed in 1 patient.Results All the VATS procedures were performed successfully,and there was no intraoperative and postoperative complication.The operation time ranged from 30 to 105 minutes with an average time of 70.5 minutes.All the intraoperative blood loss was less than 5 ml.The time of postoperative thoracic drainage was less than 48 hours,and the drainage volume ranged from 30 to 80 ml with a mean volume of 55.5 ml.The mean postoperative hospital stay was 3.5(2-4) days.The incision was small with a concealed and esthetic appearance.For 10 patients with extended thoracopscopic thymectomy,histopathology test aftre operation showed 4 patients with thymic hyperplasia,4 with thymoma,and 2 with cystofthymus.Conclusion Concealing incision VATS is a safe and feasible technique,and it can meet the esthetic requirement of patients.