胸腔镜辅助小切口手术治疗老年人胸部肿瘤

目的 探讨胸腔镜辅助小切口手术治疗老年人胸部肿瘤的手术方法及应用价值。方法 应用胸腔镜辅助小切口手术治疗老年人胸部肿瘤356例，其中肺癌228例，肺部良性肿瘤23例，食管癌62例，纵隔肿瘤39例，胸膜肿瘤4例。结果 全组无手术死亡，食管癌手术时间3．5～4．5h，平均4．0h；其他手术时间0．5～3．5h平均2．0h。术中延长手术切口至12cm 23例，占6．5％，均为中央型肺癌患者，需作支气管或肺血管成形。开胸时间5～12min，平均8min；关胸时间15～30min，平均23min。开胸过程出血量少于30ml，切口均Ⅰ期愈合。胸腔引流时间2～7d，平均2．5d、住院天数5～19d，平均11．2d。结论 胸腔镜辅助小切口手术治疗老年胸部肿瘤具有创伤小、恢复快、出血少，对心肺功能影响小，开关胸时间短，术后并发症少，手术适应证更广等优点。

Video-assisted small incision thoracic operation for the treatment of elderly patients with thoracic tumor

Objective To evaluate the clinical significance of surgical treatment for elderly patients with thoracic tumor using thoracoscopy combined with small incision. Methods From July 1997 to August 2003, video-assisted small incision thoracic operation were performed for 356 elderly patients with thoracic tumor including 228 lung cancers and 23 benign tumors, 62 esophageal cancers, 39 mediastinal tumors, and 4 pleural neoplasms. Results The mortality and morbidity showed no association with surgical procedures. The mean duration of postoperative chest tube drainage was 2.5 days and hospital stay was 11.2 days. Conclusions Video-assisted small incision thoracic operation for elderly patients with thoracic tumor has many advantages, such as minimal injury, quick recovery, less bleeding, short operation period and it influences less to lung and heart functions. It causes less complications and is of wide indications.