摘要
目的探讨全胸腔镜手术治疗非小细胞肺癌的临床经验。方法42例非小细胞肺癌患者施行全胸腔镜肺叶切除＋纵隔淋巴结清扫术。肿瘤位于左上肺叶7例，左下肺叶10例，右上肺叶9例，右中肺叶4例，右下肺叶12例。术前eTNM分期Ⅰ～Ⅱ期（T1N0M0-T2N1M0），肿瘤直径均〈5cm，无明显肺门及纵隔淋巴结肿大或胸膜肥厚。结果42例患者手术均获成功，无手术死亡。2例因淋巴结与血管粘连致密，无法在镜下分离而中转辅助小切口手术。3例因术中出血而中转开胸止血。1例因胸膜广泛粘连而中转小切口手术。所有患者手术顺利，清扫淋巴结数目（9．5±3．2）枚。手术中清扫N2淋巴结均超过3组，平均3．3组。手术时间100～400（220±37）min，术中失血量120～700（150±63）ml，术后胸腔引流时间3～12（4．5±2．1）d，术后住院时间9—31（12．2±5．0）d。结论全胸腔镜手术治疗非小细胞肺癌在技术上是安全、可行的，但要把握好手术适应证。
Objective To summarize preliminary experiences on complete video-assisted thoracoscopes lobectomy for patients with non-small cell lung cancer. Methods From October 2009 to March 2012,42 patients with non-small cell lung cancer were treated with complete video-assisted thoracoscopes lobectomy. Tumors located in the left upper lobectomy in 7 cases, 10 cases of left lower lobectomy, 9 cases of upper right lung, 4 cases of right lung, 12 cases of lower right lobectomy. Preoperative cTNM stage was Ⅰ - Ⅱ （T1N0M0 - T2N1M0）,the size of tumor was 〈 5 cm, no obvious lung and mediastinal lymph node enlargement or pleura hypertrophy. Results All operations were successful. There were （9.5 ± 3.2） pieces of lymph nodes removed. Nz lymph node cleaning was more than 3 groups,the average was 3.3 groups. The operation time was 100 - 400 （220 ± 37 ） rain, blood loss was 120 - 700 （ 150 ± 63 ） ml, duration of drainage was 3 - 12（4.5 ~ 2.1 ） d. The postoperative hosPital stay was 9 - 31（ 12.2 ± 5.0） d. Conclusion Video-assisted thoracoscopes lobectomy is technically feasible and safe, but the operation indications should be paid special attention.
出处
《中国医师进修杂志》
2013年第14期19-21,共3页
Chinese Journal of Postgraduates of Medicine
基金
2011年度福建省莆田市科技计划[2011S11（3）]
关键词
癌
非小细胞肺
胸外科手术
电视辅助
肺切除术
Carcinoma,non-small-celllung
Thoracic surgery, video-assisted
Pneumonectomy
