中国癌症杂志
中國癌癥雜誌
중국암증잡지
CHINA ONCOLOGY
2015年
8期
619-623
,共5页
乔玉磊%林宗武%奚俊杰%徐松涛%蒋伟%王群
喬玉磊%林宗武%奚俊傑%徐鬆濤%蔣偉%王群
교옥뢰%림종무%해준걸%서송도%장위%왕군
肺癌%胸腔镜%肺段切除术
肺癌%胸腔鏡%肺段切除術
폐암%흉강경%폐단절제술
Lung cancer%Thoracoscopy%Pulmonary segmentectomy
背景与目的：随着胸腔镜手术技术的提高，胸腔镜下解剖性肺段切除术日渐成熟。本文旨在研究胸腔镜肺段切除术用于治疗Ⅰ期肺癌患者的安全性、可行性及临床特点。方法：回顾性分析2008年3月—2014年1月复旦大学附属中山医院胸外科收治的临床诊断为Ⅰ期原发性支气管肺癌后接受胸腔镜解剖性肺段切除术的64例患者的临床资料，其中男性28例，女性36例，中位年龄59岁(39~86岁)。分析围术期各项参数。结果：64例患者顺利接受了胸腔镜解剖性肺段切除术。中位手术时间为120 min(90~240 min)，中位出血量为50 mL(10~200 mL)。术后中位胸管引流时间为3 d(2~7 d)，术后中位住院时间为5 d(3~23 d)。无围术期手术死亡病例，术后无严重并发症发生，无1例中转开胸，1例转为肺叶切除。51例毛玻璃样(ground glass opacity， GGO)病变患者的术后病理显示，浸润性腺癌30例，原位腺癌10例，微浸润腺癌6例，良性病变5例。结论：胸腔镜解剖性肺段切除对有经验的医师而言，是安全可行的，对临床Ⅰ期肺癌患者同时兼具了诊断和治疗的价值，尤其适用于GGO病变的患者。
揹景與目的：隨著胸腔鏡手術技術的提高，胸腔鏡下解剖性肺段切除術日漸成熟。本文旨在研究胸腔鏡肺段切除術用于治療Ⅰ期肺癌患者的安全性、可行性及臨床特點。方法：迴顧性分析2008年3月—2014年1月複旦大學附屬中山醫院胸外科收治的臨床診斷為Ⅰ期原髮性支氣管肺癌後接受胸腔鏡解剖性肺段切除術的64例患者的臨床資料，其中男性28例，女性36例，中位年齡59歲(39~86歲)。分析圍術期各項參數。結果：64例患者順利接受瞭胸腔鏡解剖性肺段切除術。中位手術時間為120 min(90~240 min)，中位齣血量為50 mL(10~200 mL)。術後中位胸管引流時間為3 d(2~7 d)，術後中位住院時間為5 d(3~23 d)。無圍術期手術死亡病例，術後無嚴重併髮癥髮生，無1例中轉開胸，1例轉為肺葉切除。51例毛玻璃樣(ground glass opacity， GGO)病變患者的術後病理顯示，浸潤性腺癌30例，原位腺癌10例，微浸潤腺癌6例，良性病變5例。結論：胸腔鏡解剖性肺段切除對有經驗的醫師而言，是安全可行的，對臨床Ⅰ期肺癌患者同時兼具瞭診斷和治療的價值，尤其適用于GGO病變的患者。
배경여목적：수착흉강경수술기술적제고，흉강경하해부성폐단절제술일점성숙。본문지재연구흉강경폐단절제술용우치료Ⅰ기폐암환자적안전성、가행성급림상특점。방법：회고성분석2008년3월—2014년1월복단대학부속중산의원흉외과수치적림상진단위Ⅰ기원발성지기관폐암후접수흉강경해부성폐단절제술적64례환자적림상자료，기중남성28례，녀성36례，중위년령59세(39~86세)。분석위술기각항삼수。결과：64례환자순리접수료흉강경해부성폐단절제술。중위수술시간위120 min(90~240 min)，중위출혈량위50 mL(10~200 mL)。술후중위흉관인류시간위3 d(2~7 d)，술후중위주원시간위5 d(3~23 d)。무위술기수술사망병례，술후무엄중병발증발생，무1례중전개흉，1례전위폐협절제。51례모파리양(ground glass opacity， GGO)병변환자적술후병리현시，침윤성선암30례，원위선암10례，미침윤선암6례，량성병변5례。결론：흉강경해부성폐단절제대유경험적의사이언，시안전가행적，대림상Ⅰ기폐암환자동시겸구료진단화치료적개치，우기괄용우GGO병변적환자。
Background and purpose:With the improvement of skill of video-assisted thoracic surgery, thoracoscopic anatomic segmentectomy becomes more and more mature. This paper aimed to study the safety, feasibility and clinical features of thoracoscopic anatomic segmentectomy for stageⅠ lung cancer.Methods:Data from 64 patients who was diagnosed as having clinicalⅠ stage lung cancer and received thoracoscopic anatomic pulmonary segmentectomy were retrospectively analyzed from Mar. 2008 to Jan. 2014. There were 28 men and 36 women with a median age of 59 years (39-86 years).Results:Sixty-four patients underwent thoracoscopic anatomic segmentectomy successfully. The median operative time was 120 min (90-240 min). The median blood loss in operation was 50 mL (10-200 mL). The median thoracic drainage time was 3 d(2-7 d). The median postoperative length of stay was 5 d(3-23 d). There was no postoperative mortality or severe complications. There was one conversion to lobectomy but no conversion to thoracotomy. There were 51 patients with ground glass opacity (GGO). Of the 51 patients, postoperative pathology showed invasive adenocarcinoma in 30, adenocarcinoma in situ in 10, minimally invasive adenocarcinoma in 6 and benign lesions in 5.Conclusion:Thoracoscopic anatomic pulmonary segmentectomy is a feasible and safe technique for a skilled doctor. Not only can it be a method of diagnosis, but also it can be a method of treatment for clinical stageⅠ lung cancer, especially for GGO in lung.
