中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

单中心连续 133 例单孔全胸腔镜手术

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目的 总结我院胸外科中心单孔全胸腔镜手术(cVATS)的临床资料,并初步探讨该手术的学习曲线、安全性及可行性。 方法 回顾性分析 2015 年 3 月至 2016 年 10 月于本医疗组行单孔 cVATS 的 133 例患者的临床病理资料,男 79 例、女 54 例,平均年龄(52.21±10.77)岁。 结果 完成单孔全胸腔镜手术 127 例,中转开胸 6 例,中转率 4.51%。其中完成肺叶切除 78 例,肺段切除 6 例;肺楔形切除 37 例,胸膜、纵隔淋巴结活检或纵隔肿瘤切除 6 例。肺叶切除组中,手术时间(148.75±34.12)min,术中出血量(118.87±59.96)ml,淋巴结清扫数目(11.25±6.15)枚,胸腔引流管留置时间(2.17±1.35)d,术后住院时间(7.58±2.59)d。 结论 对于熟练掌握多孔 cVATS 的胸外科医生,通过单孔胸腔镜手术学习曲线的培训,在完成至少 20 例肺叶切除手术后,可较熟练掌握单孔 cVATS 肺叶切除术技术;且单孔 cVATS 肺叶切除术技术安全可行,值得临床推广应用。

Objective To explore the learning curve and evaluate the safety of uniportal complete video-assisted thoracoscopic (cVATS) lobectomy. Methods We reviewed retrospectively the clinicals data of 133 patients, who underwent uniportal cVATS treatment during March 2015 and October 2016 in Sichuan Provincial Cancer Hospital. There were 79 males and 54 females at age of 52.21±10.77 years. Results All the 127 patients had completed uniportal video-assisted thoracoscopic surgery, 4.51% (6/133) converted to open surgery. There were 78 patients with lobectomy, 6 patients with segmentectomy, 37 patients with wedge resection, 6 patients with pleural, mediastinal lymph node biopsy or mediastinal tumor resection. In the lobectomy group, mean surgical time was 148.75±34.12 min, mean blood loss was 118.87±59.96 ml, mean number of lymph nodes was 11.25±6.15, the median duration of chest-tube placement was 2.17±1.35 days, and median length of stay was 7.58±2.59 days. Conclusion Based on skillful performance of the conventional thoracoscopic lobectomy, the learning curve for single port thoracoscopic lobectomy comprises at least 20 patients. The uniportal video-asisted thoracoscopic lobectomy is a safe and operable method of minimaly invasive technique, and it is worthy to apply in thoracic surgery.

关键词: 肺癌; 肺叶切除术; 电视胸腔镜手术; 单孔

Key words: Lung cancer; lobectomy; video-assisted thoracoscopic surgery; uniportal

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