扶镜手在胸腔镜肺叶切除术中的配合体会

目的总结扶镜手在胸腔镜肺叶切除术中的配合体会。方法回顾性分析2016年10月至2017年10月在我科治疗一组完成的113例胸腔镜肺叶切除术患者的相关临床资料。经胸部3个微创切口完成肺叶切除,若为恶性则加行肺门纵隔淋巴结清扫术。结果所有患者手术均成功,其中4例患者因肺门区淋巴结钙化与肺血管粘连紧密、术中较大血管破裂出血、肿瘤侵犯支气管等原因而中转开胸。平均手术时间(117.5±43.2)min,术中出血量中位数为180 mL(30～1 200 mL),术后平均住院时间为(7.2±1.4)d。围术期未出现死亡及严重并发症病例。结论胸腔镜肺叶切除术是一项团队技术,扶镜手必须熟练掌握扶镜的方法和技巧,才能保证手术安全、高效地完成。

Coordination experience of thoracoscopic assistant in video-assisted thoracoscopic lobectomy

Objective To summary the coordination experience of thoracoscopic assistant in video-assisted thoracoscopic lobectomy. Methods The relevant clinical data of 113 patients who underwent video-assisted thoracoscopic lobectomy in our first treatment group from October 2016 to October 2017 were retrospectively analyzed. Lobectomy was completed through three minimally invasive incisions in the chest, and Hilum and mediastinum lymph nodes dissection were performed for the malignant cases. Results Completely video-assisted thoracoscopic lobectomy was successfully performed in 113 patients. And 4 patients were changed to open thoracotomy since the hilum and mediastinum lymph nodes which were calcified adhered closely to pulmonary vessels, or the larger vessel burst in operation, or the bronchi was invaded by tumors. The mean operation time was(117.5±43.2) min, the median blood loss was 180 mL(30-1 200 mL), and the mean postoperative hospital stay was(7.2 ±1.4) d. No deaths or serious complications occurred during perioperative period.Conclusion The video-assisted thoracoscopic lobectomy is a team technique. It requires thoracoscopic assistant to master the relevant methods and skills expertly for safely and efficiently performing the operation.