摘要
目的评价第五肋间入路单孔胸腔镜下肺部手术的疗效、安全性和方法学。方法纳入在云南省滇东北中心医院接受单孔胸腔镜下肺部手术的76例患者为研究对象[男性43例,女性33例,年龄18~74岁,平均(53±3)岁]。含恶性病变34例,良性病变42例;病灶位于左肺上叶14例,左肺下叶10例,左肺上/下叶2例,右肺上叶27例,右肺中叶7例,右肺下叶11例,右肺上/下叶1例,右肺上/中叶2例,右肺上/中/下叶2例。采集患者基线资料,常规方法完成单孔胸腔镜手术,入路为腋中线-腋后线4~5cm,记录手术耗时、出血量、术后引流量、拔管时间、手术相关并发症,随访6~12月,分析疗效、安全性、方法学。结果76例手术均成功,术中出血10~200mL,平均55mL。术中术后无输血,无二次手术止血,胸液引流100~600mL,平均260mL。术后1~5天拔出闭式引流管,平均拔管时间2.6d。2例术后液气胸经保守治疗痊愈,术后平均住院时间8.2d,无患者围术期死亡。结论经第五肋间单孔胸腔镜下实施各种肺部手术安全、高效、简便、易于在基层推广普及。
Objective To evaluate the efficacy,safety and methodology of single-port thoracoscopic pulmonary surgery via the fifth intercostal approach.Methods A total of 76 patients who underwent single-port thoracoscopic pulmonary surgery at the Northeast Yunnan Central Hospital were included as the research subjects(43 males and 33 females,aged 18 to 74 years old,with an average age of(53±3)years).There were 34 cases of malignant lesions and 42 cases of benign lesions.The lesions were located in the upper lobe of the left lung in 14 cases,the lower lobe of the left lung in 10 cases,the upper/lower lobe of the left lung in two cases,the upper lobe of the right lung in 27 cases,the middle lobe of the right lung in seven cases,the lower lobe of the right lung in 11 cases,the upper/lower lobe of the right lung in one case,the upper/middle lobe of the right lung in two cases,and the upper/middle/lower lobe of the right lung in two cases.Baseline data of the patients were collected.Single-port thoracoscopic surgery was completed by conventional methods,with an approach of 4-5 cm from the midaxillary line to the posterior axillary line.The operation time,blood loss,postoperative drainage volume,extubation time,and surgery-related complications were recorded.The patients were Followed-up for 6-12 months to analyze the efficacy,safety,and methodology.Results All 76 operations were successful.The intraoperative blood loss was 10-200 mL,with an average of 55 mL.There was no blood transfusion during or after the operation,no secondary surgery for hemostasis,and the thoracic fluid drainage was 100-600 mL,with an average of 260 mL.The closed drainage tube was removed 1-5 days after the operation,with an average of 2.6 days.Two cases of postoperative hydrothorax and pneumothorax recovered after conservative treatment.The average postoperative hospital stay was 8.2 days.There was no perioperative death.Conclusions The implementation of various pulmonary surgeries under single-port thoracoscopy through the fifth intercostal space is safe,efficient,simple and easy to be popularized at the grassroots level.
作者
马丹
肖建峰
王繁静
罗元佳
马应
曹蔚
MA Dan;XIAO Jianfeng;WANG Fanjing;LUO Yuanjia;MA Ying;CAO Wei(Department of Cardiothoracic Surgery,Northeast Yunnan Central Hospital,Zhaotong Yunnan 657000,China;Medical Image,Dali University,Dali Yunnan 67100,China)
出处
《云南医药》
2025年第6期24-27,共4页
Medicine and Pharmacy of Yunnan
关键词
肺部手术
单孔胸腔镜
有效性
安全性
方法学
pulmonary surgery
single-port thoracoscopy
effectiveness
safety
methodology
