全电视胸腔镜肺叶切除术的临床应用(附186例报告)

摘要

Objective To evaluate the postsurgery effects of completed video-assisted thoracic surgery (VATS) lobectomy and the indication for non-small cell lung cancer cases (NSCLC).Methods Retrospective analysis of 186 patients received completed VATS technique surgery for lobectomy from October 2007 to July 2010.Results All surgeries ( 186 cases) were performed successfully, and there was no death and severe postsurgery complications.Among the 186 patients, 1.6％( 3/186 ) were switched to open thoracic operation.Up to now, all patients was alive, and the longest time for return was 31 months.Compared with regular lobectomy, bleeding, time for postoperative drainage and hospital stay were all decreased in completed VAST ( P ＜ 0.05 ).In NSCLC cases, the average number of dissected lymph node was 14.5 ( 4 - 22 ).Conclusion VATS lobectomy is safe and feasible.It is particularly useful for early stage NSCLC (esp.Ⅰ-Ⅱb) with proper indication.%目的:探讨全电视胸腔镜(video-assisted thoracic surgery,VATS)肺叶切除术临床疗效及在非小细胞肺癌治疗中的适应征.方法:回顾分析了中南大学湘雅二医院心胸外科普胸专科2007年10月至2010年7月间186例全VATS肺叶切除术患者资料.结果:186例患者均顺利完成手术,无手术死亡及术后重大并发症;术中中转开胸3例(占总病例的1.6%).回访所有患者均生存,最长回访31个月.全VATS手术患者手术中失血量、术后引流时间、平均住院日,均较常规开胸肺叶切除手术缩短(P<0.05).非小细胞肺癌患者手术中清扫淋巴结4～22(平均数目14.5)个.结论:全VATS行肺叶切除术安全有效,对于I-IIb期非小细胞肺癌患者是合适的适应征,但需依据指征合理应用.