电视胸腔镜肺叶切除术缩短患者术后住院时间

目的：通过患者术后住院时问评价电视胸腔镜行肺叶切除术的微创意义。方法：总结2001．5～2002．5我院通过电视胸腔镜技术所行肺口叶切除术30例。患者年龄6～66岁。良性病变14例，肺癌16例。行单肺叶切除28例，双肺叶切除2例，肺癌病例均行肺门纵隔淋巴结清扫。术中辅助一7～9cm切口作为操作切口。结合内镜器械和常规器械解剖肺门结构及肺裂，推结器结扎肺血管，切割缝合器处理支气管。术毕用0／4可吸收线皮内缝合切口。结果：术中无中转大切口开胸，除1例术后反复出现阵发性室上性心动过速，无其它严重并发症发生。术后患者疼痛轻，多数口服止痛药即可。术后恢复快，最早第三天即户外活动。6例术后5天出院，23例术后7天出院，1例术后9天出院，平均术后住院6天，较本院开胸肺叶切除术后常规9天出院住院时间明显缩短。结论：电视胸腔镜肺叶切除为微创伤手术，术后患者恢复快，疼痛轻，住院时间较普通开胸手术明显缩短。

Video-assisted Thoracoscopic Lobectomy Decreased Patients Postoperative Hospital Stay

Objective:To evaluate the postoperative hospital stay in patients with mini-invasiveness of video-assissted thoracoscopic lobectomy.Methods:Thirty cases of VATS lobectomy performed in our hospital during May 2001 to May 2002 were reviewed.The patients were 6-66 years old,including 14 cases of benign lesions and 16 lung cancers Single lobectomy was performed in 28 cases,and double lobectomy in 2.Hilar and mediastinal lymph nodes were dissected in cases of lung cancer.A 7-9cm incision was made for operation.The hilar components and fissures were dissected with endoscopic and conventional equipments,the pulmonary vessels were ligated with ligature-pushing machine,and the branchi was cut with endoscopic linear cutter and stapler.The incision was closed intracutaneously with 0/4 absorbable surgical suture at the end of operation.Results:There was no switch to conventional thoracotomy during operation and no severe complications occurred except one case having supraventricular tachycardia after operation.Pain was slight and could be relieved by oral analgesic.Recovery from operation was rapid and the patients could go outdoor on the third day after operation.Twenty-three cases were discharged from the hospital on the 7 th day after operation,6 cases on the 5 th day and 1 case on the 9 th day.The average postoperative hospital stay was 6 days and it was markedly shorter than the hospital stay of lobectomy from conventional thoracotomic approach,which was routinely 9 days in our hospital.Conclusion:VATS lobectomy was a kind of mini-invasive operation and patients had rapid recovery with slight pain and the hospital stay was markedly less compared with conventional thoracotomy.