3D 电视胸腔镜肺占位病变切除术

目的：探讨Storz 3D电视胸腔镜手术治疗肺部疾病的可行性。方法2013年7月应用Storz 3D电视胸腔镜分别行肺叶切除联合系统性淋巴结清扫和病变局部切除各2例。选择腋中线第7肋间为胸腔镜观察孔，腋前线第3或第4肋间2～3 cm切口为胸腔镜主操作孔，腋后线靠后第8或9肋间2 cm切口为第1副操作孔。佩戴3D偏振眼镜，在3D效果的手术画面上，行局部病灶切除或肺叶切除，恶性肿瘤者行系统性淋巴结清扫。结果4例均手术成功，无中转开胸，无术后并发症，无死亡。手术时间分别为36、38、72、90 min，出血量分别为5、10、35、80 ml，术后住院时间分别为3、3、5、7 d。术后随访2个月，均无并发症发生。结论 Storz 3D电视胸腔镜手术安全可行，相对于VATS，视野更逼真，操作更灵活稳定。

Three Dimensional Video-assisted Thoracoscopic Surgery for Pulmonary Space-occupying Lesions

Objective To investigate the feasibility of Storz three dimensional video-assisted thoracoscopic surgery （3D-VATS） for the treatment of pulmonary disease. Methods In July 2013, under 3D video-assisted thoracoscope （Storz）, lobectomy plus systematic lymphadenectomy was performed on 2 cases and local resection was performed on 2 cases respectively .The seventh intercostal space along the midaxillary line was selected as observation port of the thoracoscope ; an incision of 2-3 cm in length made at the third or fourth intercostal space along the anterior axillary line was used for main operating port and a 2 cm incision at the eighth or ninth intercostal space along the posterior axillary line was used for the first assisted operating port .Wearing 3D polarization glasses , we performed local excision or lobectomy combined with systematic lymphadenectomy on the 3D effect operation screen. Results Four operations were accomplished successfully , without conversion to open surgery .No complications or death occurred.The operative time was 36, 38, 72 and 90 min, respectively; the blood loss was 5, 10, 35 and 80 ml, respectively and postoperative hospital stay was 3, 3, 5 and 7 d, respectively.No complications were observed during the follow-up of 2 months. Conclusion Compared with VATS, 3D-VATS is safe and feasible for pulmonary disease with a lifelike view and improved flexibility .