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目的探讨胸腔镜辅助小切口在良性肺叶切除及肺癌根治术中的临床应用价值。方法2004年1月至2009年1月,共收治124例肺良性病变行肺叶切除及肺部恶性肿瘤行肺癌根治术患者。其中支气管扩张6例,毁损肺8例,肺空洞并曲菌球形成6例,炎性假瘤9例,原发性肺癌95例。其中周围型肺癌52例,中央型肺癌43例。良性病变单纯肺叶切除,恶性病变行肺叶切除+纵隔淋巴清扫86例,全肺切除9例,其中3例心包部分切除、心包内处理肺血管。108例在胸腔镜辅助6～8cm小切口下完成手术,其中16例因胸腔广泛粘连或肺部肿瘤较大、术中血管损伤出血等原因,延长切口至10～12cm,部分撑开肋骨完成手术。结论胸腔镜辅助小切口行肺叶切除术适用于胸腔粘连、肺分裂不全及各早、中及部分局部晚期病例,适应证比纯镜下手术增宽、费用低,又具备胸腔镜切口美容、痛苦少、恢复快、对心肺功能影响小等优点。
Objective To investigate the clinical value of thoracoscopic assisted small incision in the treatment of benign lobectomy and radical resection of lung cancer. Methods From January 2004 to January 2009, a total of 124 patients with lung benign lesions underwent lobectomy and lung cancer underwent radical resection of lung cancer. Bronchiectasis in which 6 cases, 8 cases of lung damage, pulmonary cavitation and aspergillosis in 6 cases, inflammatory pseudotumor in 9 cases, 95 cases of primary lung cancer. Among them, 52 cases of peripheral lung cancer and 43 cases of central lung cancer. Benign lesions simple lobectomy, malignant lesions underwent lobectomy + mediastinal lymphadenectasis in 86 cases, pneumonectomy in 9 cases, of which 3 cases of partial resection of the pericardium, pericardial treatment of pulmonary vessels. One hundred and eighty patients underwent thoracoscopic surgery assisted by small incision of 6 ~ 8cm. Among them, 16 patients underwent extended thoracotomy to 10 ~ 12cm due to extensive thoracic adhesions or large lung tumors and intraoperative blood vessel injury. . Conclusions Thoracoscopic assisted small-incision lobectomy is suitable for the treatment of thoracic adhesions, pulmonary fissures and early, middle and late local cases. The indications are wider than those under pure microscopy and have low cost. They also have the advantages of thoracoscope incision beauty and pain Less, faster recovery, less impact on cardiopulmonary function.