CAJ | 학술논문

目的：探讨经左胸入路电视胸腔镜手术（ VATS）治疗偏向左侧胸腔胸腺肿瘤的可行性。方法2004年2月-2013年2月胸腔镜胸腺切除手术200例，经左胸入路电视胸腔镜胸腺切除手术42例（左胸入路组）。患者术中均采用右侧卧位，采用全身麻醉，健侧单肺通气，通过前侧操作孔切除胸腺并切断左侧胸腺静脉，术后经左胸腔留置引流管1根。经右胸入路（右胸入路组）患者158例，比较2组临床资料。结果42例患者均手术顺利，无严重并发症及围手术期死亡病例。单纯胸腺切除术36例，胸腺扩大切除术6例，其中因肿瘤侵犯周围器官中转开胸4例，平均手术时间（118．3±23．7）min，平均术中出血（99．7±58．3） ml。术后随访（35．5±22．2）个月，均未见肿瘤复发。与右胸入路组比较，左胸入路病变最大径明显大（ t ＝3．592， P ＜0．05）。结论经左胸入路电视胸腔镜胸腺切除术有效可行，是左侧胸腔胸腺肿瘤首选的手术切除方式。
목적：탐토경좌흉입로전시흉강경수술（ VATS）치료편향좌측흉강흉선종류적가행성。방법2004년2월-2013년2월흉강경흉선절제수술200례，경좌흉입로전시흉강경흉선절제수술42례（좌흉입로조）。환자술중균채용우측와위，채용전신마취，건측단폐통기，통과전측조작공절제흉선병절단좌측흉선정맥，술후경좌흉강류치인류관1근。경우흉입로（우흉입로조）환자158례，비교2조림상자료。결과42례환자균수술순리，무엄중병발증급위수술기사망병례。단순흉선절제술36례，흉선확대절제술6례，기중인종류침범주위기관중전개흉4례，평균수술시간（118．3±23．7）min，평균술중출혈（99．7±58．3） ml。술후수방（35．5±22．2）개월，균미견종류복발。여우흉입로조비교，좌흉입로병변최대경명현대（ t ＝3．592， P ＜0．05）。결론경좌흉입로전시흉강경흉선절제술유효가행，시좌측흉강흉선종류수선적수술절제방식。
Objective To evaluate the feasibility of the left thoracic approach video-assisted thoracoscopic operation (VATS) toward thymoma in the left pleural cavity .Methods From 2004 February to 2013 February, 200 cases of thoraco-scopic thymectomy operation were enrolled , through left thoracic approach video-assisted thoracoscopic thymectomy operation was 42 cases ( left thoracic approach group ) .The patients in the right lateral decubitus , general anesthesia is used , the con-tralateral one lung ventilation , through the front side hole thymectomized and cut off the left thymic vein , after operation with 1 tube for left pleural indwelling drainage .Through right thoracic approach ( right thoracic approach group ) in 158 cases, compare the clinical data of the 2 groups.Results 42 patients received successful operation , no serious complications and pe-ri-operation period death cases .Simple thymus resection in 36 cases, thymus expand resection in 6 cases, the tumor invasion of adjacent organs for thoracotomy in 4 cases, the average operation time was (118.3 ±23.7) min, the average intraoperative bleeding (99.7 ±58.3) ml.Postoperative follow-up (35.5 ±22.2) months, showed no tumor recurrence .Compared with the right thoracic approach group , left thoracic approach the maximum diameter of the lesions was significantly greater ( t =3.592, P <0.05).Conclusion Through left thoracic approach video-assisted thoracoscopic thymectomy is effective , is the frist choice of left pleural thymoma resection .