CAJ | 학술논문

目的探讨全胸腔镜手术治疗非小细胞肺癌的临床经验.方法 42例非小细胞肺癌患者施行全胸腔镜肺叶切除+纵隔淋巴结清扫术.肿瘤位于左上肺叶7例,左下肺叶10例,右上肺叶9例,右中肺叶4例,右下肺叶12例.术前cTNM分期Ⅰ～Ⅱ期(T1N0M0～T2N1M0),肿瘤直径均＜5cm,无明显肺门及纵隔淋巴结肿大或胸膜肥厚.结果 42例患者手术均获成功,无手术死亡.2例因淋巴结与血管粘连致密,无法在镜下分离而中转辅助小切口手术.3例因术中出血而中转开胸止血.1例因胸膜广泛粘连而中转小切口手术.所有患者手术顺利,清扫淋巴结数目(9.5±3.2)枚.手术中清扫N2淋巴结均超过3组,平均3.3组.手术时间100 ～ 400(220± 37) min,术中失血量120～700 (150±63) ml,术后胸腔引流时间3～ 12(4.5±2.1)d,术后住院时间9～ 31(12.2±5.0)d.结论全胸腔镜手术治疗非小细胞肺癌在技术上是安全、可行的,但要把握好手术适应证.
목적 탐토전흉강경수술치료비소세포폐암적림상경험.방법 42례비소세포폐암환자시행전흉강경폐협절제+종격림파결청소술.종류위우좌상폐협7례,좌하폐협10례,우상폐협9례,우중폐협4례,우하폐협12례.술전cTNM분기Ⅰ～Ⅱ기(T1N0M0～T2N1M0),종류직경균＜5cm,무명현폐문급종격림파결종대혹흉막비후.결과 42례환자수술균획성공,무수술사망.2례인림파결여혈관점련치밀,무법재경하분리이중전보조소절구수술.3례인술중출혈이중전개흉지혈.1례인흉막엄범점련이중전소절구수술.소유환자수술순리,청소림파결수목(9.5±3.2)매.수술중청소N2림파결균초과3조,평균3.3조.수술시간100 ～ 400(220± 37) min,술중실혈량120～700 (150±63) ml,술후흉강인류시간3～ 12(4.5±2.1)d,술후주원시간9～ 31(12.2±5.0)d.결론 전흉강경수술치료비소세포폐암재기술상시안전、가행적,단요파악호수술괄응증.
Objective To summarize preliminary experiences on complete video-assisted thoracoscopes lobectomy for patients with non-small cell lung cancer.Methods From October 2009 to March 2012,42 patients with non-small cell lung cancer were treated with complete video-assisted thoracoscopes lobectomy.Tumors located in the left upper lobectomy in 7 cases,10 cases of left lower lobectomy,9 cases of upper right lung,4 cases of right lung,12 cases of lower right lobectomy.Preoperative cTNM stage was Ⅰ-Ⅱ (T1N0M0-T2N1M0),the size of tumor was ＜ 5 cm,no obvious lung and mediastinal lymph node enlargement or pleura hypertrophy.Results All operations were successful.There were (9.5 ± 3.2) pieces of lymph nodes removed.Nz lymph node cleaning was more than 3 groups,the average was 3.3 groups.The operation time was 100-400 (220 ± 37) min,blood loss was 120-700 (150 ± 63) ml,duration of drainage was 3-12(4.5 ± 2.1) d.The postoperative hospital stay was 9-31 (12.2 ± 5.0) d.Conclusion Video-assisted thoracoscopes lobectomy is technically feasible and safe,but the operation indications should be paid special attention.