CAJ | 학술논문

目的：探讨完全电视胸腔镜肺叶切除的安全性及可靠性。方法：2012年9月～2013年8月，我科共施行全胸腔镜肺叶切除10例，男7例，女3例；年龄40～73岁。腋后线第九肋间稍偏后作为观察孔；腋前线及腋中线之间第四肋间4～5 cm切口，作为主操作孔；腋前线第七肋间作为副操作孔。施行解剖性肺叶切除，其中右上肺3例、右中肺1例、右下肺2例、左上肺1例、左下肺3例。结果：全组病人均顺利完成手术，无中转开胸，无围手术期死亡。手术时间105～240 min；术中出血量40～210 ml；清扫淋巴结4～12枚；胸腔引流管放置时间3～10 d；术后住院时间8～14 d。术后出现肺部感染1例，房颤1例，经积极治疗后痊愈。全组病人随访3～14个月无复发。结论：完全电视胸腔镜肺叶切除术是一种安全、有效、更加微创的术式。
목적：탐토완전전시흉강경폐협절제적안전성급가고성。방법：2012년9월～2013년8월，아과공시행전흉강경폐협절제10례，남7례，녀3례；년령40～73세。액후선제구륵간초편후작위관찰공；액전선급액중선지간제사륵간4～5 cm절구，작위주조작공；액전선제칠륵간작위부조작공。시행해부성폐협절제，기중우상폐3례、우중폐1례、우하폐2례、좌상폐1례、좌하폐3례。결과：전조병인균순리완성수술，무중전개흉，무위수술기사망。수술시간105～240 min；술중출혈량40～210 ml；청소림파결4～12매；흉강인류관방치시간3～10 d；술후주원시간8～14 d。술후출현폐부감염1례，방전1례，경적겁치료후전유。전조병인수방3～14개월무복발。결론：완전전시흉강경폐협절제술시일충안전、유효、경가미창적술식。
Objective:To assess the safety and feasibility in application of complete video-assisted thoracoscopic lobectomy.Methods:Between September 2012 and August 2013,we treated ten patients by complete video-assisted thoracoscopic lobectomy.The patients included seven men and three women with a mean age of 61.5 years(range,40-73 years),who underwent anatomic lobectomy by route of the incision for observation in the 9th intercostal space at the posterior axillary line,the major incision(4-5 cm) made in the 4th intercostal space between anterior axillary line and mid-axillary line,and the assis-tant incision in the 7th intercostal space at the anterior axillary line.Excision of the right upper lobe in 3,right middle lobe in 1,right lower lobe in 2,left upper lobe in 1 and left lower lobe in 3.Results: The procedure was successfully completed in the total 10 cases without conversion to open surgery,no death occurred in perioperative period.The average operation time was 168.9 min(range,105-240 min),and average blood loss was 126 ml(range,40-210 ml).Average number of lymph nodes dissected was 8.3(range,4-12) and average duration of drainage was 6.5 days(range,3-10 days).Postoper-ative hospital stay ranged from 8 to 14 days( mean,11.2 days).Postoperative lung infection occurred in one case and arrhythmia occurred in another one, yet were managed by symptomatic treatment.There was no relapse for the total patients in follow-up by 3 to 14 months.Conclusion: The complete video-assisted thoracoscopic lobectomy is a safe and feasible surgical procedure with minimal invasiveness .