CAJ | 학술논문

【目的】探讨单操作孔全胸腔镜肺叶切除术的临床应用体会。【方法】2013年10月至2014年11月本院共施行63例肺癌单操作孔全胸腔镜下肺叶切除术。术中取第8肋间腋中线切口约1.5 cm 作为胸腔镜观察孔,腋前线第4或5肋间4~5 cm 切口作为单操作孔。所有手术均通过单操作孔完成肺叶切除术,同时行系统淋巴结清扫。【结果】全组手术时间78~169(102±27)min,术中出血90~280(165±30)mL ,术中淋巴结清扫数为3~29(11.8±3.7)枚,术后胸管引流量300~1120(550±120)mL ,术后住院时间5~12(7.5±2.3)d 。所有患者均康复出院,未发生严重并发症及围术期死亡。【结论】在具备丰富的普胸手术基础,镜下操作积累一定经验,术前筛选把握适应证,术中细致谨慎操作的前提下,单操作孔全胸腔镜肺叶切除术治疗肺癌安全可靠,且具有创伤小,出血少,恢复快的优势。
【목적】탐토단조작공전흉강경폐협절제술적림상응용체회。【방법】2013년10월지2014년11월본원공시행63례폐암단조작공전흉강경하폐협절제술。술중취제8륵간액중선절구약1.5 cm 작위흉강경관찰공,액전선제4혹5륵간4~5 cm 절구작위단조작공。소유수술균통과단조작공완성폐협절제술,동시행계통림파결청소。【결과】전조수술시간78~169(102±27)min,술중출혈90~280(165±30)mL ,술중림파결청소수위3~29(11.8±3.7)매,술후흉관인류량300~1120(550±120)mL ,술후주원시간5~12(7.5±2.3)d 。소유환자균강복출원,미발생엄중병발증급위술기사망。【결론】재구비봉부적보흉수술기출,경하조작적루일정경험,술전사선파악괄응증,술중세치근신조작적전제하,단조작공전흉강경폐협절제술치료폐암안전가고,차구유창상소,출혈소,회복쾌적우세。
[Objective]To study the clinical application of single-port thoracoscopic lobetomy on lung canc-ers.[Methods]A total of 63 lung cancers undergone single port thoracoscopic lobectomy in our department were selected from October 2013 to November 2014.An approximate 1.5 cm surgery incision as the thoraco-scope camera window was made at the 8th intercostal across the mid-axillary line,while an approximate 4 ~5cm incision as the primary working window was made at the 4th or 5th intercostal across the anterior axillary line.All cases underwent single-port thoracoscopic lobectomy with systematic (mediastinal )lymph node dis-section.[Results]The average operative time was 102 ± 27 min(78 ~ 1 69 min),the amount of intraoperative bleeding was 1 65±30 ml (90~280 mL),the number of lymph node dissection was 1 1.8 ± 3.7 (3~29),the amount of post-operative thoracic tube drainage was 550±120 ml (300~1 120 mL),and the hospital stay was 7.5±2.3 d (5 ~12 d).All patients recovered smoothly and there were no serious perioperative complications and no death occurred.[Conclusion]With basic skills of general thoracic surgercal techniques,experience of thoracoscope,preoperative selection of cases with appropriate indications,and carefully intraoperative per-formance,single-port thoracoscopic lobectomy is a safer,minimally invasive,lower hemorrhage,and quicker recovery method for lung cancers.