全胸腔镜下肺叶切除手术112例治疗分析

目的探索全胸腔镜下肺叶切除术的临床应用价值和效果。方法应用全胸腔镜下肺叶切除手术对2009年7月至2012年6月我院收治的112例(VATS组)周围型肺部肿瘤或其他病变患者进行治疗,并选择2009年7月之前在我院接受传统开胸肺部手术患者100例作为对照组,进行组间治疗情况比较。结果 VATS组术后病理诊断所有患者共有原发性肺癌89例,其他恶性肿瘤3例,其他良性疾病20例;VATS组与对照组在手术时间、出血量、淋巴结清除数量三方面比较差异不显著,无统计学意义(P>0.05);术后肺不张、肺炎、脓胸或胸腔积液、支气管胸膜瘘等并发症的情况比较差异均较显著,具统计学意义(P<0.05)。结论全胸腔镜下肺叶切除术目前已具有相当可靠和有效的技术保障,同时还兼具了安全和微创的优势,在充分掌握该术式当前适应证的情况下,尤其适用于早期周围型肺癌和需要施行肺叶切除的良性病变治疗。

The Analysis of 112 Cases with the Treatment of Thoracoscopic Lobectomy

Objective To explore the value of the application and clinical effect of thoracoscopic lobectomy.Methods 112 cases(VATS group) peripheral lung tumors or other lesions in our hospital from July 2009 to June 2012 were treated with thoracoscopic lobectomy surgery.100 patients in our hospital with traditional open lung surgery before July 2009 were chosen as the control group.The treatment situation between the two groups was compared.Results There was a total of 89 cases of primary lung cancer and 3 examples of other malignancies,20 cases of benign disease in the pathological diagnosis of all patients in VATS group.The differences were not significant for the VATS group and the control group in three aspcts such as the operation time,amount of bleeding,and the number of lymph nodes,and there was not statistically significance(P >0.05).There was comparatively significant difference in postoperative atelectasis,pneumonia,empyema or pleural effusion,bronchial fistula complications and with statistical significance(P<0.05).Conclusion Thoracoscopic lobectomy has a fairly reliable and effective technical support,and it also possesses the advantages of safety and minimally invasiveness.In the case of fully mastered the surgical indications,early peripheral lung cancer and needs to enforce lobectomy benign treatment is particularly suitable.