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目的探讨单操作孔胸腔镜肺癌根治术的可行性和有效性。方法回顾性分析我院自2010年10月—2014年12月完成的单操作孔胸腔镜肺癌根治术279例。胸腔镜观察孔取腋后线第8或第9肋间,长约1.5cm,操作孔取腋前线与锁骨中线之间第4或第5肋间,长3~4cm,术后常规放置1或2根胸腔引流管。结果 279例患者手术中,2例因术中出血中转开胸。患者手术时间104~250(155.38±22.43)min,术中出血量140~245(180.26±21.30)ml,清扫淋巴结11~24(13.06±0.71)枚,术后胸腔引流量500~850(671.66±98.60)ml,术后留置胸管时间2~5(3.97±0.93)d,术后住院时间4~9(7.14±1.17)d。214例患者术后随访5~67个月,无复发和转移。结论单操作孔胸腔镜肺癌根治术是安全、可行的手术方式。
Objective To investigate the feasibility and effectiveness of single-hole thoracoscopic lung cancer radical surgery. Methods A retrospective analysis of our hospital since October 2010 -2012 in December completed a single operation hole thoracoscopic lung cancer radical resection in 279 cases. Thoracoscopic observation hole to take the axillary line 8 or 9 intercostal space, length of about 1.5cm, take the operation hole axillary line and clavicular midline between the 4th or 5th intercostal space, length 3 ~ 4cm, after the conventional placement of 1 or 2 thoracic drainage tube. Results Of the 279 patients who underwent surgery, 2 were converted to thoracotomy due to intraoperative bleeding. The operative time was 104 ~ 250 (155.38 ± 22.43) min, the intraoperative blood loss was 140 ~ 245 (180.26 ± 21.30) ml, the lymph nodes were 11 ~ 24 (13.06 ± 0.71), the postoperative chest drainage was 500 ~ 850 (671.66 ± 98.60) ml, postoperative chest tube placement time 2 ~ 5 (3.97 ± 0.93) d, postoperative hospital stay 4 ~ 9 (7.14 ± 1.17) d. 214 patients were followed up for 5 to 67 months without recurrence and metastasis. Conclusions Single operation thoracoscopic lung cancer radical surgery is a safe and feasible surgical approach.