南方医科大学学报 ›› 2014, Vol. 34 ›› Issue (08): 1210-.

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两孔法电视胸腔镜手术治疗肺部疾病:附105例报告

杨胜利,杨劼,古卫权,叶俊,朱乐伟,王飞,罗灵军,刘梅芳   

  • 出版日期:2014-08-20 发布日期:2014-08-20

Single-port video-assisted thoracoscopic surgery for pulmonary diseases: analysis of 158
cases

  • Online:2014-08-20 Published:2014-08-20

摘要: 目的探讨两孔法全胸腔镜手术在肺部疾病治疗中应用的可行性及临床价值。方法2009年10月~2013年12月,采用两
孔法全胸腔镜行肺部疾病手术治疗105例患者,其中肺叶切除术19 例,肺楔形切除术34例,气胸52例行肺大疱切除术及胸膜粘
连术。结果全组患者两孔法手术101例,1例中转开胸手术,3例改为三孔手术;手术时间20~200(50.6±36.8)min,术中出血量
10~300(70±56.9)ml。术后胸腔引流管放置时间2~14(4.2±3.2)d,术后住院时间3~16(5.4±3.8)d。术后肺持续漏气6例,肺
不张2例,肺部感染2例,余患者术后恢复顺利。结论两孔法全胸腔镜行胸部疾病的诊断和治疗在技术上是安全、可行的,具有
创伤小、恢复快等优点。

Abstract: Objective To assess the clinical value of single-port video-assisted thoracoscopic surgery (VATS) for treatment of
pulmonary diseases. Methods From October, 2009 to December, 2013, 105 patients with pulmonary diseases were scheduled
for single-pore VATS for pulmonary lobectomy (19 patients), wedge resection of the lung (34 patients), and bullae resection
and pleurodesis for spontaneous pneumothorax or pulmonary bleb (52 patients). Results Of the 105 patients, 101 patients
underwent single-port VATS; the procedure was converted to open thoracotomy in 1 patient and to conventional three-port
VATS in 2 patients. The operative time was 50.6±36.8 min (20-200 min) with intraoperative blood loss of 70±56.9 ml (10-300 ml),
thoracic drainage time of 4.2±3.2 days (2-14 days), and postoperative hospital stay of 5.4±3.8 days (3-16 days). Postoperative
complications of the procedures included prolonged air leakage (6 cases) and atelectasis (2 cases). All the other patients
recovered smoothly without serious complications. Conclusion Single-port VATS is a safe and efficient procedure that allows
rapid postoperative recovery and is a method of choice for selected patients with pulmonary diseases.