[1]钱俊①,周超,沈宇舟,等.单操作孔胸腔镜手术1.5 cm操作孔取出标本：小切口，大标本[J].中国微创外科杂志,2018,18(7):661-663.
　Qian Jun,Zhou Chao*,Shen Yuzhou*,et al.Single Utility Port Video-assisted Thoracoscopic Surgery Extracting Specimen From a 1.5 cm Access Thoracotomy Incision: Small Incision, Large Specimen[J].Chinese Journal of Minimally Invasive Surgery,2018,18(7):661-663.
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单操作孔胸腔镜手术1.5 cm操作孔取出标本：小切口，大标本()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
18
期数:
2018年7期
页码:
661-663
栏目:
经验交流
出版日期:
2018-10-11

文章信息/Info

Title:
Single Utility Port Video-assisted Thoracoscopic Surgery Extracting Specimen From a 1.5 cm Access Thoracotomy Incision: Small Incision, Large Specimen
作者:
钱俊①; 周超; 沈宇舟; 黄平; 李文涛**
上海交通大学附属胸科医院胸外科，上海200030
Author(s):
Qian Jun;  Zhou Chao*;  Shen Yuzhou*;  et al.
*Department of Thoracic Surgery, Shanghai Chest Hospital of Shanghai Jiao Tong University, Shanghai 200030, China
关键词:
单操作孔; 胸腔镜手术; 切口长度; 切口并发症
Keywords:
Single utility port; Video-assisted thoracoscopic surgery; Incision length; Incision complications
文献标志码:
B
摘要:
目的探讨一种安全、可行、实用的1.5 cm操作孔标本取出的临床价值。方法2017年5～6月我们成功实施单操作孔胸腔镜手术87例，全胸腔镜下完成病灶切除（包括肺叶切除、肺段切除、肺楔形切除、纵隔肿瘤切除、活检术及全肺切除），从1.5 cm操作孔取出手术标本。结果82例（94.3%）使用此法均较为顺利取出手术标本，1例（1.1%）左上肺切除病例延长切口至3.0 cm后取出标本，1例（1.1%）纵隔肿瘤延长切口至3.5 cm后取出标本，3例（3.4%）全肺切除延长切口至4.0 cm后取出标本。术后切口美观，发生切口脂肪液化1例，切口感染1例，切口皮下气肿2例，无其他严重并发症。结论此法术后切口美观，能够取出大部分标本，必要时适当延长切口均能顺利取出手术标本，是一种安全、可行、实用的小切口(1.5 cm)标本取出法。
Abstract:
ObjectiveTo investigate a safe, feasible and practicable method for specimen extraction technique with a 1.5 cm access thoracotomy incision.MethodsFrom May to June 2017, we conducted 87 cases of single utility port video-assisted thoracoscopic surgery excision of the lesion (including lobectomy, segmentectomy, wedge resection, mediastinal tumor resection, biopsy and pneumonectomy). The specimen was extracted from the 1.5 cm incision.ResultsThe surgical specimens were smoothly extracted in 82 cases (94.3%). One patient (1.1%) underwent left upper lung specimen extraction by expanding the incision to 30 cm. One patient (1.1%) with mediastinal tumor underwent expanding the incision to 3.5 cm. And 3 patients (34%) of pneumonectomy were given incision expanding to 4.0 cm to extract the specimen. After operation, the incisions had good appearance. There were 1 case of fat liquefaction, 1 case of incision infection, and 2 cases of subcutaneous emphysema. There were no other serious complications.ConclusionsThis incision has good appearance,and most of the specimens can be extracted from the insion. The specimens can be extracted by expanding the incision appropriately as necessary. It is a safe, feasible and practicable method for specimen extraction with a 1.5 cm access thoracotomy incision.

参考文献/References:

[1]Mc Kenna Rj ,Houck W, Fuller CB. Video-assisted thoracic surgery lobectomy: experience with 1,100 cases. Ann Thorac Surg,2006,81(2):421-425.
[2]李志新,隋锡朝,王冲,等.高龄(≥70岁)早期非小细胞肺癌胸腔镜术后生存的预后因素分析.中国微创外科杂志,2016,16(2):97-100.
[3]周清华,范亚光,王颖,等.中国肺部结节分类、诊断与治疗指南(2016年版).中国肺癌杂志,2016,19(12):793-798.
[4]顾恺时,主编.顾恺时胸心外科手术学.第1版.上海：上海科学技术出版社,2003.836-838.
[5]朱乐伟, 杨劼, 古卫权,等.双孔法全胸腔镜肺叶切除术治疗肺良性疾病192例分析.中国微创外科杂志,2017,17(6):481-482.
[6]刘冰,林钢,刘敬伟,等.2 cm单孔胸腔镜肺叶切除术的临床应用.中国胸心血管外科临床杂志,2017,24(7):566-568.
[7]李鹏飞,赖玉田,周坤,等.应用Clavien-Dindo分级系统对肺癌患者术后并发症分级及危险因素分析.中国肺癌杂志, 2017, 20(4):264-271.
[8]Sabaté S, Mazo V, Canet J. Predicting postoperative pulmonary complications: implications for outcomes and costs. Curr Opin Anesthesiol,2014,27(2):201-209.
[9]Langeron O, Carreira S, le Sache F, et al. Postoperative pulmonary complications updating. Ann Fr Anesth Reanim, 2014, 33(7-8):480-483.
[10]Stiles BM, Poon A, Giambrone GP, et al. Incidence and factors associated with hospital readmission after pulmonary lobectomy. Ann Thorac Surg,2016,101(2):434-442.
[11]Madani A, Jr Fiore JF, Wang Y, et al. An enhanced recovery pathway reduces duration of stay and complications after open pulmonary lobectomy. Surgery,2015,158(4):899-908.
[12]沈明敬,徐中华,陈勇兵,等.胸腔镜手术治疗消失肺综合征.中国微创外科杂志,2017, 17(5)：411-414.
[13]李艳霞, 张中和.抗凝在肺栓塞治疗中的地位及方法.中国实用外科杂志,2010,30(12):999-1001.

备注/Memo

备注/Memo:
基金项目：上海市胸科医院科技发展基金（2014YZDC20100）**通讯作者，E-mail:li_wen_tao_sph@163.com ①（昆明医科大学附属云南省德宏州人民医院胸外科，芒市678400）
更新日期/Last Update: 2018-10-11