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目的探讨全电视胸腔镜(VATS)下解剖性肺段切除术的可行性及安全性。方法回顾性分析2010年11月至2011年7月期间南京医科大学第一附属医院对26例肺部病变患者行全电视胸腔镜下解剖性肺段切除术的临床资料,其中男8例、女18例,年龄13～81(53.2±3.1)岁。23例肺部结节病变患者中13例直接手术,10例毛玻璃样改变患者术前定位3例,直接手术7例;3例非肺结节病变(支气管扩张、肺大泡、肺囊肿)患者均直接施行手术。结果顺利完成手术26例,手术时间150～250(193.7±7.3)min,术中出血量10～200(65.7±12.7)ml,肿瘤患者清扫淋巴结4～7(5.1±0.3)组,清扫淋巴结4～16(12.3±0.5)枚,无手术死亡及并发症,术后胸腔引流时间3～7(3.9±0.4)d。术后均顺利出院,对肿瘤患者术后随访3～6个月内暂无复发、转移。结论全电视胸腔镜下解剖性肺段切除术安全、可行。
Objective To investigate the feasibility and safety of anatomic segmentectomy under total video-assisted thoracoscopic surgery (VATS). Methods The clinical data of 26 cases of pulmonary lesions undergoing total-video thoracoscopic anatomic segmentectomy from January 2010 to July 2011 were retrospectively analyzed. There were 8 males and 8 females 18 cases, aged 13 ~ 81 (53.2 ± 3.1) years old. Of the 23 patients with pulmonary nodular lesions, 13 received direct surgery, 10 had frosted glass-like lesions, 3 were preoperatively positioned, and 7 received direct surgery. Three patients with non-pulmonary nodular lesions (bronchiectasis, bullae, and cysts) All direct operation. Results The operation was completed successfully in 26 cases, the operation time was 150 ~ 250 (193.7 ± 7.3) min, the intraoperative blood loss was 10 ~ 200 (65.7 ± 12.7) ml, the tumor patients’ lymph nodes 4 ~ 7 (5.1 ± 0.3) ~ 16 (12.3 ± 0.5), no operative mortality and complications, postoperative chest drainage time 3 ~ 7 (3.9 ± 0.4) d. All patients were discharged smoothly, no recurrence and metastasis were found in the patients with cancer who were followed up for 3 to 6 months. Conclusion All-video thoracoscopic anatomic segmentectomy is safe and feasible.