中华胸心血管外科杂志
中華胸心血管外科雜誌
중화흉심혈관외과잡지
Chinese Journal of Thoracic and Cardiovascular Surgery
2013年
7期
399-401
,共3页
吴卫兵%陈亮%朱全%邵永丰%张石江
吳衛兵%陳亮%硃全%邵永豐%張石江
오위병%진량%주전%소영봉%장석강
胸腔镜检查%肺切除术%肺肿瘤
胸腔鏡檢查%肺切除術%肺腫瘤
흉강경검사%폐절제술%폐종류
Thoracoscopy%Pneumonectomy%Lung neoplasms
目的 探讨全胸腔镜肺段切除术的手术安全性和可行性.方法 回顾分析2010年9月至2012年11月50例全胸腔镜解剖性肺段切除治疗ⅠA期周围型非小细胞肺癌,肿瘤直径(1.35±0.48) cm,N1、N2淋巴结采样为阴性,行系统淋巴结清扫.单独离断切除肺段的动、静脉,通过肺段间的膨胀萎陷交界确定肺段平面,肺段间分离均使用直线切割缝合器.结果 平均手术(191.5±50.4)min,平均术中出血(49.2±54.6) ml,平均胸管引流(3±1)天.术中分离肺段间肺实质钉仓平均使用(3.9±0.8)枚.每例淋巴结清扫平均(12.6±2.8)枚,(6.0±1.5)组.术后30天无死亡,无严重并发症发生.平均随访11.4个月.随访期无复发、转移病例.结论 全胸腔镜肺段切除术安全、可行,结合淋巴结清扫可治疗ⅠA期非小细胞肺癌.
目的 探討全胸腔鏡肺段切除術的手術安全性和可行性.方法 迴顧分析2010年9月至2012年11月50例全胸腔鏡解剖性肺段切除治療ⅠA期週圍型非小細胞肺癌,腫瘤直徑(1.35±0.48) cm,N1、N2淋巴結採樣為陰性,行繫統淋巴結清掃.單獨離斷切除肺段的動、靜脈,通過肺段間的膨脹萎陷交界確定肺段平麵,肺段間分離均使用直線切割縫閤器.結果 平均手術(191.5±50.4)min,平均術中齣血(49.2±54.6) ml,平均胸管引流(3±1)天.術中分離肺段間肺實質釘倉平均使用(3.9±0.8)枚.每例淋巴結清掃平均(12.6±2.8)枚,(6.0±1.5)組.術後30天無死亡,無嚴重併髮癥髮生.平均隨訪11.4箇月.隨訪期無複髮、轉移病例.結論 全胸腔鏡肺段切除術安全、可行,結閤淋巴結清掃可治療ⅠA期非小細胞肺癌.
목적 탐토전흉강경폐단절제술적수술안전성화가행성.방법 회고분석2010년9월지2012년11월50례전흉강경해부성폐단절제치료ⅠA기주위형비소세포폐암,종류직경(1.35±0.48) cm,N1、N2림파결채양위음성,행계통림파결청소.단독리단절제폐단적동、정맥,통과폐단간적팽창위함교계학정폐단평면,폐단간분리균사용직선절할봉합기.결과 평균수술(191.5±50.4)min,평균술중출혈(49.2±54.6) ml,평균흉관인류(3±1)천.술중분리폐단간폐실질정창평균사용(3.9±0.8)매.매례림파결청소평균(12.6±2.8)매,(6.0±1.5)조.술후30천무사망,무엄중병발증발생.평균수방11.4개월.수방기무복발、전이병례.결론 전흉강경폐단절제술안전、가행,결합림파결청소가치료ⅠA기비소세포폐암.
Objective To evaluate the safety and feasibility of totally thoracoscopic anatomic pulmonary segmentectomy (TTAS) for the treatment of the peripheral stage ⅠA non small cell lung cancer(NSCLC).Methods The study involved 50 consecutive patients undergoing totally thoracoscopic anatomic segmentectomy (TTAS) from September 2010 to November 2012 in the First People's Hospital affiliatied to Nanjing Medical University.The diameter of the tumors were less than 2 cm [(mean diameter(1.35 ±0.48) cm].All lymph node sampling of N1 and N2 were neglive,All patients received symtematic lymph node dissection.The pulmonary vessels were individually ligated,and the bronchi were closed using an endoscopic stapler.The intersegmental plane was identified using the demarcation between the resected(inflated) and preserved(collapsed) lungs.Staplers were used for intersegmental dissection.Results The mean operative time and intraoperative bleeding were (191.5 ± 50.4) min and (49.2 ± 54.6) ml respectively.The chest tube drainage duration was (3 ± 1) days.The number of stapler cartridges used for intersegmental division was 3.9 ±0.8.The mean number of lymph nodes and nodal stations dissected were 12.6 ± 2.8 and 6.0 ± 1.5 respectively.No mortality and complications were observed 30 days after the surgery.Further,no local recurrence or metastases were observed during follow-up.Conclusion Totally thoracoscopic anatomic segmentectomy(TTAS) is a feasible and safe technique.With systematic lymph node dissection,TTAS can be a reasonable therapeutic option for stage ⅠA NSCLC.
