总结单操作孔全胸腔镜肺叶切除术 (VATS)的初步经验。

2009年12月至2015年5月间江苏省肿瘤医院共进行单操作孔全胸腔镜下肺叶(肺段)切除术71例[其中男性33例，女性38例；年龄38～72岁，平均(55.5 ± 6.9)岁]，其中1例左上肺叶袖状切除术，2例肺段切除术。

单操作胸腔镜肺叶切除术手术时间108～320 min，平均 (162.9 ± 56.8)min；操作孔长度2.5～6.0 cm，平均(3.2±0.8)cm；每例患者淋巴结清扫枚数目8～21枚，平均 (13.4 ± 4.6)枚；其中2例术中出血，中转开胸，其余均手术顺利。胸腔闭式引流时间术后3～19 d，平均 (3.8±3.1)d；住院时间7～35 d，平均 (9.8 ± 5.6)d；无围手术期死亡及重大并发症发生。

单操作孔VATS肺叶切除术安全、可靠，是创伤更小的胸腔镜下手术方式，具有很好的临床推广前景。

This study summed up an initial experience of a single utility video-assisted thoracoscopic surgery (VATS) lobectomy.

A total of 71 [male 33, female 38; mean age (55.5 ± 6.9 )years old, range 38-72], who underwent major pulmonary resection (segmentectomy, lobectomy, sleeve lobectomy) through a consecutive VATS using a single utility from Dec. 2009 to May 2015, were included in this study. Lobectomy was performed in most patients (n=38), and sleeve lobectomy was performed in 1 patient, and segmentectomy in 2 patients.

The mean time of the operation, in 71 patients who were completed by two-incisions VATS lobectomy, was [(162.9 ± 56.8)minutes (range, 108-320) minutes]. The utility incision length was [(3.2 ± 0.8)cm (range, 2.5-6.0)cm]. The total number of dissected lymph nodes per patient was [(13.4±4.6)range, 8-21 range]. Conversion to thoracotomy was performed in 2 patients (2.8%) due to bleeding at pulmonary arterial branch. The chest tube was removed on postoperative day [(3.8 ± 3.1)range, 3-19 range], and the mean time of hospitalization was [(9.8 ± 5.6)days, range 7-35 days]. There was no occurrence of major perioperative morbidity and mortality.

In the hands of experienced VATS surgeons, it is safe and feasible to perform VATS lobectomy with a single utility.