CAJ | 학술논문

背景与目的肺上沟瘤的外科手术治疗具有挑战性。胸腔镜辅助下手术治疗肺上沟瘤的临床研究较少。本研究旨在初步评估胸腔镜应用于肺上沟瘤切除术中的可行性及安全性。方法2010年1月-2013年6月在重庆医科大学附属第一医院胸心外科确诊的肺上沟瘤患者10例，最终有6例接受外科手术治疗，包括胸腔镜联合前径路3例及联合后径路3例。研究指标包括：①围手术期死亡率；②手术对肿瘤切除的完整性；③手术的一般资料及术后并发症；④手术后1年复发及转移情况。结果无围手术期死亡患者。肿瘤及受累胸壁均为完整切除。手术平均时间为242 min。术中平均出血量为308 mL。平均住院时间为14 d。1例患者术后出现肺部感染，经使用抗生素治愈。术后无严重并发症。所有患者随访1年均无局部复发或远处转移。结论胸腔镜联合前/后径路行肺上沟瘤切除术具有实用价值，符合术者视野角度和操作习惯，便于确定胸壁切除的准确范围，有利于肺上沟瘤手术的安全、规范实施。
배경여목적폐상구류적외과수술치료구유도전성。흉강경보조하수술치료폐상구류적림상연구교소。본연구지재초보평고흉강경응용우폐상구류절제술중적가행성급안전성。방법2010년1월-2013년6월재중경의과대학부속제일의원흉심외과학진적폐상구류환자10례，최종유6례접수외과수술치료，포괄흉강경연합전경로3례급연합후경로3례。연구지표포괄：①위수술기사망솔；②수술대종류절제적완정성；③수술적일반자료급술후병발증；④수술후1년복발급전이정황。결과무위수술기사망환자。종류급수루흉벽균위완정절제。수술평균시간위242 min。술중평균출혈량위308 mL。평균주원시간위14 d。1례환자술후출현폐부감염，경사용항생소치유。술후무엄중병발증。소유환자수방1년균무국부복발혹원처전이。결론흉강경연합전/후경로행폐상구류절제술구유실용개치，부합술자시야각도화조작습관，편우학정흉벽절제적준학범위，유리우폐상구류수술적안전、규범실시。
Background and objective hTe surgical resection for pancoast tumors remains challenging. hTere are only few reports explaining the use of VATS in the treatment of Pancoast tumors. hTe aim of this study is to assess whether the use of video-assisted thoracoscopic surgery (VATS) for the surgical treatment of Pancoast tumors was feasible and safe.Meth-ods Between Janunary 2010 and June 2013, ten patients who were diagnosed as Pancoast tumors were recruited. Six patients were accepted for surgical treatment either through an anterior (n=3) or a posterior approach (n=3) combined with VATS. hTe observation index of this study included: Operation safety and mortality; hTe integrity of the tumor resection; General data of operation and postoperative complications; Tumor recurrence and metastasis at twelve months atfer operation.Results hTere were no perioperative deaths. hTe average time of operation time was 242 min. hTe radical en bloc resection of the involved chest wall were done in each patients. hTe average amount of blood loss was 308 mL and the average time of hospital stay was 14 d. Only one patient had postoperative pneumonia and recovered atfer use of antibiotics. hTere was none of severe postop-erative complications. No patient developed a local recurrence or distant metastasis within twelve months.Conclusions hTe use of VATS has practical value in the management of Pancoast tumors. It is useful to make an accurate extent of the resection of chest-wall and provides a better exposure. Anterior or posterior approach with VATS surgery can facilitate the safety manage-ment of Pancoast tumors.