肺部小结节62例胸腔镜手术治疗

目的探讨电视胸腔镜手术（VATS）诊治孤立性肺部小结节的价值。方法 2004年2月～2010年7月,对62例肺孤立性小结节（直径〈3cm）应用电视胸腔镜手术行肺小结节病灶切除,术中快速冷冻切片,对恶性病变按恶性肿瘤手术原则进一步手术,良性病变则结束手术。结果诊断恶性病变38例,其中32例原发性肺癌行胸腔镜辅助小切口肺癌根治术,2例双侧肺癌和4例肺转移癌行胸腔镜病灶切除术;24例术中病理诊断为肺良性病变,仅行病灶切除术。良性病变随访3～12个月,平均7.5个月,无复发。结论电视胸腔镜辅助小切口诊治肺部小结节,创伤小,诊断准确,具有很大优势。

Diagnosis and treatment of 62 cases with small pulmonary nodules via video-assisted thoracic surgery

Objective To investigate the efficacy of video-assisted thoracoscopic surgery（VATS） in diagnosis and treatment of small pulmonary nodules.MethodsFrom February 2004 to July 2010,62 patients with small solitary pulmonary nodule（〈3cm in diameter）were treated by video-assisted thoracoscopic surgery.The nodules were removed during the operation,and then based on the results of quick pathological examination,malignant cases received further surgeries.ResultsTotally 38 patients were diagnosed with malignant disease.32 of them received small-incision radical lobectomy for primary lung cancer,small-incision resection of the lesions were performed on 6 patients who had bilateral（2 cases）or metastatic lung cancer（4 cases）.Benign lesions were confirmed in 24 patients during the operation,and were removed by local resection.The 24 benign cases were followed up for 3 to 12 montha（mean,7.5 months）,none of them had recurrence.ConclusionVATS is effective in the diagnose and treatment of small pulmonary nodules.