CAJ | 학술논문

目的探讨全胸腔镜全肺切除在非小细胞肺癌手术治疗中的安全性和有效性.方法 2009年1月至2012年6月共施行全胸腔镜下全肺切除术治疗非小细胞肺癌16例,年龄46～ 83岁,平均62.2岁.手术全部通过3个胸腔镜切口完成,不撑开肋间,完全在胸腔镜视野下使用腔镜器械进行解剖性全肺切除和系统性淋巴结清扫.结果全组手术过程顺利,未发生严重并发症,无围手术期死亡,无中转开胸病例.平均手术(174.6±52.7)min；无输血病例,术中平均出血(121.8±87.5) ml；每例清扫淋巴结平均(5.2±1.1)组,清扫淋巴结平均(16.0±3.2)个；术后平均胸腔闭式引流(4.2±1.8)天；术后平均住院(13.0±3.1)天.结论全胸腔镜下全肺切除治疗非小细胞肺癌安全可行,并未增加全肺切除术围手术期风险,值得总结经验并加以推广应用.
목적 탐토전흉강경전폐절제재비소세포폐암수술치료중적안전성화유효성.방법 2009년1월지2012년6월공시행전흉강경하전폐절제술치료비소세포폐암16례,년령46～ 83세,평균62.2세.수술전부통과3개흉강경절구완성,불탱개륵간,완전재흉강경시야하사용강경기계진행해부성전폐절제화계통성림파결청소.결과 전조수술과정순리,미발생엄중병발증,무위수술기사망,무중전개흉병례.평균수술(174.6±52.7)min；무수혈병례,술중평균출혈(121.8±87.5) ml；매례청소림파결평균(5.2±1.1)조,청소림파결평균(16.0±3.2)개；술후평균흉강폐식인류(4.2±1.8)천；술후평균주원(13.0±3.1)천.결론 전흉강경하전폐절제치료비소세포폐암안전가행,병미증가전폐절제술위수술기풍험,치득총결경험병가이추엄응용.
Objective To evaluate the feasibility and safety of the completely thoracoscopic pneumonectomy for nonsmall cell lung cancer (NSCLC).Methods From January 2009 to June 2012,16 patients with NSCLC received completely thoracoscopic pneumonectomy.Three incisions were made in the thoracoscopic pneumonectomy.Without softening the intercostal space,we used thoracoscopic equipment for anatomic lung resection under thoracoscopic vision totally and the sequence of operations of systematic lymph node dissection was basically the same as conventional thoracotomy.Evaluation indicators including lymph node dissection,operation time,bleeding loss,time of drainage,pathological staging,hospitalization time,and postoperative complications.Results All 16 patients with non-small cell lung cancer were operated safely,without serious complications and death in the period of operation.There was no case of conversion to thoracotomy.The mean operation time was(174.6 ± 52.7) minutes.There was no blood transfusion cases in the completely thoracoscopic group,whose blood loss is (121.8 ± 87.5) ml.The mean groups of lymph nodes dissection was (5.2 ± 1.1),The mean time of drainage was (4.2 ±1.8),The mean hospitalization time was (13.0 ± 3.1).Conclusion Completely thoracoscopic pneumonectomy for non-small cell lung cancer should achieve the same objective of thoracotomy in terms of effectiveness and thoroughness.By no increasing perioperative risk,it is worth summarizing the experience of completely thoracoscopic pneumonectomy for non-small cell lung cancer and promoting it to application.