CAJ | 학술논문

目的总结采用单孔胸腔镜手术(single port VATS,SPVATs)治疗胸部疾病的临床经验,探讨其在胸部疾病治疗中的应用价值.方法 2011年3月至2011年5月32例单孔胸腔镜手术中男28例,女4例；年龄18～72岁,平均(26.5±9.2)岁.病种包括自发性气胸27例(其中2例行双侧同期手术),不明原因胸腔积液3例,双肺多发结节和肺转移瘤各1例.术中均使用自主研发的双关节手术器械和专用切口保护器,操作过程与传统胸腔镜手术类似.行肺大疱切除27例,脓性纤维板剥脱胸腔冲洗引流术3例,壁层胸膜活检术1例,肺楔形切除术1例.结果全组手术顺利,无中转传统VATS或开胸手术,无死亡及并发症发生.全组手术时间(22.O±9.5) min,术中出血(14.5±8.8)ml,术后插管(3.1±0.6)天,总住院(6.8±1.6)天.结论单孔胸腔镜手术治疗部分胸部疾病近期疗效满意,并发症少,患者创伤更小、恢复快.
목적 총결채용단공흉강경수술(single port VATS,SPVATs)치료흉부질병적림상경험,탐토기재흉부질병치료중적응용개치.방법 2011년3월지2011년5월32례단공흉강경수술중남28례,녀4례；년령18～72세,평균(26.5±9.2)세.병충포괄자발성기흉27례(기중2례행쌍측동기수술),불명원인흉강적액3례,쌍폐다발결절화폐전이류각1례.술중균사용자주연발적쌍관절수술기계화전용절구보호기,조작과정여전통흉강경수술유사.행폐대포절제27례,농성섬유판박탈흉강충세인류술3례,벽층흉막활검술1례,폐설형절제술1례.결과 전조수술순리,무중전전통VATS혹개흉수술,무사망급병발증발생.전조수술시간(22.O±9.5) min,술중출혈(14.5±8.8)ml,술후삽관(3.1±0.6)천,총주원(6.8±1.6)천.결론 단공흉강경수술치료부분흉부질병근기료효만의,병발증소,환자창상경소、회복쾌.
Objective Summarize the experience of single port video-assisted thoracoscopic surgery (SPVATS).Evaluate the value of SPVATS for thoracic diseases.Methods 32 patients underwent SPVATS from March 2011 to May 2011,including 28 males and4 females,with an average age of (26.5 ±9.2) years (ranged 18-72 years).There were twenty-seven cases of spontaneous pneumothorax ( including 2 cases of single stage bilateral surgery),three cases of unknown pleural effusion,one case of bilateral pulmonary nodules,and one case of pulmonary metastasis tumor.Results All procedures were successfully accomplished without conversion to conventional multi-port VATS or open approach.There was no major complication or operative death.All procedures were using self-developed specialized surgical instruments and two-incision joint protection.The procedures inluded resection of lung bullae in 27 cases,purulent drainage fiber stripping pleural lavage in 3,parietal pleural biopsy in 1,and pulmonary wedge resection in 1.The operating time ranged from (22.0 ± 9.5 ) min.The average intraoperative blood loss was ( 14.5 ± 8.8 )ml.The mean chest tube duration was (3.1 ± 0.6 ) days.The average postoperative hospital stay was (6.8 ± 1.6 ) days.Conclusion SPVATS is a new approach for treatment of thoracic diseases.This technique is preferred as a minimally invasive and cosmetic procedure with decreased operative time,quickened postoperative recovery,few complications,and satisfactory short-term outcome.