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中华腔镜外科杂志(电子版) ›› 2018, Vol. 11 ›› Issue (02) : 80 -84. doi: 10.3877/cma.j.issn.1674-6899.2018.02.005

所属专题: 文献

论著

0°镜头在单孔胸腔镜肺癌根治术中应用
何嘉1, 徐沛然2, 马冬捷1, 刘洪生1, 李单青1,()   
  1. 1. 100730 北京协和医院胸外科
    2. 100730 北京,清华大学北京协和医学院临床医学专业(八年制)
  • 收稿日期:2018-03-12 出版日期:2018-04-30
  • 通信作者: 李单青

Application of 0-degree lens in uniportal video-assisted thoracoscopic radical surgery of lung cancer

Jia He1, Peiran Xu2, Dongjie Ma1, Hongsheng Liu1, Shanqing Li1,()   

  1. 1. Department of Thoracic Surgery, Peking Union Medical College Hospital, Beijing 100730, China
    2. Cilinical Medicine Major, Peking Union Medical College, Tsinghua University, Beijing 100730, China
  • Received:2018-03-12 Published:2018-04-30
  • Corresponding author: Shanqing Li
  • About author:
    Corresponding author: Li Shanqing, Email:
引用本文:

何嘉, 徐沛然, 马冬捷, 刘洪生, 李单青. 0°镜头在单孔胸腔镜肺癌根治术中应用[J/OL]. 中华腔镜外科杂志(电子版), 2018, 11(02): 80-84.

Jia He, Peiran Xu, Dongjie Ma, Hongsheng Liu, Shanqing Li. Application of 0-degree lens in uniportal video-assisted thoracoscopic radical surgery of lung cancer[J/OL]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2018, 11(02): 80-84.

目的

总结应用0°镜头的单孔胸腔镜肺癌根治术的操作经验及患者临床资料,探索0°镜头的优、缺点。

方法

回顾性分析分别来自北京协和医院和澳门仁伯爵综合医院的35例肺癌患者(包含1例转移癌)经0°镜头下单孔胸腔镜肺癌根治术(包括肺叶/全肺切除+纵隔淋巴结清扫)的临床数据。其中男性22例、女性13例,年龄(63.11 ± 9.89)岁。

结果

34例手术成功完成、1例中转开胸,患者均顺利出院。统计修正后,手术时间(218.59 ± 36.80)min,术中出血量(177.27 ± 94.62) ml,淋巴结清扫数(19.03 ± 6.39)枚,术后带管时间(5.74 ± 4.34)d,术后住院时间(5.97 ± 1.85)d。5例患者出现术后并发症,占全组病例14.3%。

结论

对比国外相关文献,本队列患者的手术时间、术中出血量、术后并发症发生率接近,淋巴结清扫数稍高,证明了0°镜头下单孔胸腔镜肺癌根治术的可行性与安全性。0°镜头可能在单孔胸腔镜术中存在潜在优势。

Objective

To summarize the patients` clinical data and the experience of the 0-degree lens application into the uniportal video assisted thoracoscopic surgery (VATS) of radical resection of lung cancer and discuss its strengths and weaknesses.

Methods

Clinical data and surgical outcome of 35 lung cancer patients [22 male and 13 female, a mean age of (63.11 ± 9.89 ) years] from Peking Union Medical College Hospital and Centro Hospitalar Conde De S. Januá rio, who underwent the uniportal VATS radical resection of lung cancer, including lobectomy/pneumonectomy and systemic mediastinal lymph nodes dissection, were collected from their clinical files.

Results

34 patients′ operations were successfully performed under uniportal VATS and 1 patient needed thoracotomy. The mean operation time is( 218.59 ± 36.80) minutes and the mean blood loss is( 177.27 ± 94.62 )ml. The mean number of retrieved lymph nodes is (19.03 ± 6.39). The mean chest tube duration is (5.74 ± 4.34) days and the mean postoperative hospital stay is (5.97 ± 1.85) days. 5 patients had postoperative complications, 14.3% of all patients. All the patients were discharged in good health.

Conclusions

Comparing with the researches published by foreign thoracic surgeons, the operating time, blood loss, and postoperative complication rate of this cohort have no significant difference and the number of retrieved lymph nodes is higher. Therefore, this study proved the feasibility and safety of uniportal VATS for lung cancer under 0-degree lens and its potential advantage.

图1 部分肺癌患者的CT资料
图2 比较0°镜头和30°镜头在单孔胸腔镜手术中的差别
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