摘要
目的探讨胸腔镜辅助胸壁小切口术(VAMTS)行肺叶切除加淋巴廓清在治疗肺癌方面的应用价值。方法收集2004年5月至2005年6月胸外科行VAMTS的肺癌患者30例,手术选择腋中线7或8肋间2 cm长切口作镜孔,在腋前线或腋后线第4或第5肋间隙作长约8～10 cm辅助小切口,使用胸腔镜器械或普通的长手术器械进行肺血管和支气管的解剖,纵隔淋巴结廓清(MLNR)在镜下和(或)直视下进行,于镜孔小切口安放闭式引流管1枚。结果手术时间50～210 min,平均123 min,术中出血量不多,术中、术后均未输血,术后胸腔引流带管平均时间3.9 d,术后住院平均时间为9.9 d。全组无手术死亡、切口感染、呼吸衰竭、支气管胸膜瘘等并发症。结论VAMTS行肺切除或肺叶切除具有创伤小、术野照明好、手术时间短、出血少、术后恢复快、住院时间短等优点。VAMP3行肺叶切除加淋巴廓清可作为肺癌治疗方式的一种补充,比较适用于Ⅰ～Ⅱ期、肿块直径<6 cm、CT或PET-CT检查淋巴结无明显肿大或转移的周边型肺癌,尤其是年龄大、心肺功能差、不能耐受标准开胸手术者。
Objective To evaluate the clinical application of VAMTS in lung cancer patients.Meth- ods Between May 2004 and June 2005,30 patients with lung cancer applied VAMTS.The minimalthoracto- my from 8 to 10 cm was made at fourth or fifth intercostal space and lobectomy was undergone for convertion- al or dedicated endoscopic instruments.Some mediastinum lymphnode(MLN)resection were performed.Re- suits Operative time from 50 to 210 minutes and average 123 minutes.The intraoperative blood loss is less, and without blood transfusion.The average drawing duct time is 3.9 days.No death caused by operation and postoperative syndromes.Conclusion VAMTS wounds much less,operative scale lumination is better,opera- tive time shorter,blood loss less,and recover more quickly.The hospitalization time is shorter.The VAMTS with MLNR is regarded as an implement of lung cancer remedy,fits to stageⅠ-Ⅱ,diameter<6 cm,periph- ery lung cancer that local lymph nodes don't swell or transfer from CT or PET-CT,particularly,the older, hardly endure conventional operation.
出处
《肿瘤研究与临床》
CAS
2007年第4期261-262,共2页
Cancer Research and Clinic
关键词
肺肿瘤
胸腔镜检查
纵隔
淋巴结切除术
Lung neoplasms
Thoracoscopy
Mediastinum
Lymph node excision
