电视胸腔镜在孤立性肺结节诊治中的应用

目的 探讨电视胸腔镜（VATS）在孤立性肺结节（SPN）诊治中的应用价值。方法 对38例SPN患者进行VATS下肺叶楔形切除并送冰冻病理诊断。若为良性病变则终止手术；若为恶性肿瘤则VATS辅助小切口下行肺叶切除及系统性纵隔淋巴结清扫。结果 良性SPN7例，转移性SPN2例，均在VATS下行肺叶楔形切除术，原发恶性SPN29例，其中27例在VATS辅助小切口下行肺叶切除及系统性纵隔淋巴结清扫，2例患者因高龄混合性通气功能障碍行VATS下肺叶楔形切除术。所有病例均手术过程顺利，无手术死亡，无术中、术后严重并发症。术中冰冻报告与术后病理符合率达100％。结论 VATS应用于SPN的诊治能最大限度地减少创伤和并发症，VATS下肺叶楔形切除术可能代替传统的开胸肺叶切除术，成为诊治SPN的基本术式。

Application of video-assisted thoracoscopic surgery to diagnose and treatment solitary pulmonary nodule

Objective To explore the clinical application methods and value of video-assisted thoracic surgery (VATS)in diagnosis and treatment solitary pulmonary nodule(SPN).Methods There were 38 patients with SPN, VATS pulmonary wedge resections had been performed and the biopsy had been made in the operations.It would be end off if The SPN was benign,but pulmonary lobectomies and mediastinum lymphonodus clearing would be system- aticness performed by VATS and small incision thoracic operation if the SPN was nicious.Results There were 7 eases with benign SPN,2 cases with ambulant SPN,each of them had been performed by VATS pulmonary wedge resections.There were 29 cases primary nicious SPN,27 cases among them were performed lobectomies and medi- astinum lymphonodus clearing systematically by VATS and small incision thoracic operation.The other two were performed pulmonary wedge resections by VATS because they were senility incorporate with ventilating function ob- struction.All cases were performed favourably,there were no deaths of all patients,there were no severe peri-opera- tire complications.The correspond rate of biopsy diagnosis was 100% between peri-operative and postoperative.Con- clusion VATS for SPN is effective,safe,make the best of lessen complications.Just so we have a grasp strictly for indications,it is possible that pulmonary wedge resections by VATS take the place of pulmonary lobectomies by tra- ditional incision as well as underlie primeness mode for diagnose and treatment SPN.