论文部分内容阅读
目的探讨胸腔镜下全肺切除术治疗肺部疾病的治疗价值。方法回顾性分析2013年1月至2015年10月在我院胸外科行胸腔镜全肺切除术的34例患者的临床资料及术后随访结果。男26例、女8例,年龄35~69(53.8±7.7)岁。结果全组34例患者中,2例中转腔镜辅助小切口手术,其余32例(良性病变4例,恶性28例)行全胸腔镜手术。平均手术时间(182.5±52.4)min,术中平均出血量(217.1±1 834.8)ml。对于肺癌患者,清扫淋巴结平均5组,平均15.4枚;术后引流时间平均(6.0±1.7)d,术后住院时间平均(7.6±1.8)d;围术期无死亡,11例患者发生术后并发症(34.3%),以肺部感染为主(8例)。随访10(1~21)个月,1例术后2个月发生支气管胸膜瘘,1例术后3个月因心搏骤停猝死,2例患者复发转移分别于术后16个月、17个月死亡。结论胸腔镜下全肺切除术安全且可行,但对肺癌患者其远期疗效尚需进一步研究。
Objective To investigate the value of thoracoscopic pneumonectomy in the treatment of pulmonary diseases. Methods The clinical data and postoperative follow-up results of 34 patients who underwent thoracoscopic pneumonectomy in our department from January 2013 to October 2015 were retrospectively analyzed. 26 males and 8 females, aged 35 to 69 (53.8 ± 7.7) years old. Results Among the 34 patients in the whole group, 2 cases underwent transclinal endoscopy assisted small incision surgery and the remaining 32 cases (4 cases of benign disease and 28 cases of malignant) underwent thoracoscopic surgery. The average operation time (182.5 ± 52.4) min, intraoperative blood loss (217.1 ± 1 834.8) ml. In patients with lung cancer, the average number of lymph nodes dissected was 15.4. The average drainage time after surgery was 6.0 ± 1.7 days, and the average postoperative hospital stay was 7.6 ± 1.8 days. There were no deaths during the perioperative period and 11 postoperative complications Complications (34.3%) were mainly pulmonary infections (8 cases). One (1) postoperative bronchopleural fistula occurred 2 months after operation, and one patient died of sudden cardiac arrest at 3 months after operation. The recurrence and metastasis of the two patients were respectively at 16 months and 17 months after operation Months of death. Conclusions Thoracoscopic pneumonectomy is safe and feasible, but its long-term efficacy needs further study.