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目的:探讨全胸腔镜下非小细胞肺癌手术的临床应用。方法:2007年1月～2010年1月,对50例非小细胞肺癌患者采用全胸腔镜下肺叶切除+纵隔淋巴结清扫术。通过胸部3个微创切口非直视下完成肺叶切除和淋巴结清扫。结果:50例患者手术均成功,无围术期死亡。1例中转开胸。右胸清扫淋巴结(12.5±1.3)个,左胸清扫淋巴结(11.3±1.2)个。手术时间为(122±30)min,术中出血量(200±52)ml,术后引流管留置时间(2.2±1.3)天,术后住院时间(9.3±3.4)天。术后随访1～20个月(平均9.1个月),1例原发肺腺癌(ⅠB期)术后13个月发生同侧胸膜腔转移,余均未复发和转移。结论:全胸腔镜下肺叶切除手术是安全可行的。
Objective: To investigate the clinical application of thoracoscopic non-small cell lung cancer surgery. Methods: From January 2007 to January 2010, thoracoscopic lobectomy and mediastinal lymph node dissection were performed on 50 patients with non-small cell lung cancer. Thoracotomy and lymphadenectomy were performed under the direct view of 3 minimally invasive incisions through the chest. Results: All the 50 patients were successfully operated and no perioperative death was found. One case transferred to open chest. Right chest dissection lymph nodes (12.5 ± 1.3), left chest dissection lymph nodes (11.3 ± 1.2). The operation time was (122 ± 30) min, the amount of bleeding during operation was (200 ± 52) ml, the postoperative drainage tube indwelling time was 2.2 ± 1.3 days and the postoperative hospital stay was (9.3 ± 3.4) days. The patients were followed up for 1 to 20 months (average 9.1 months). One case of primary lung adenocarcinoma (stage IB) had ipsilateral pleural cavity metastasis at 13 months after operation, and the rest had no recurrence and metastasis. Conclusion: Thoracoscopic lobectomy is safe and feasible.