[1]沈宇舟 钱俊① 周超 黄平 李文涛**.单操作孔胸腔镜前、后亚段联合部分切除术治疗右上肺深部结节6例[J].中国微创外科杂志,2019,01(2):167-169.
　Shen Yuzhou*,Qian Jun,Zhou Chao*,et al.Single Utility Port Videoassisted Thoracoscopic S2b+S3a Segmental Resection for Right Upper Pulmonary Deep Nodules: Report of 6 Cases[J].Chinese Journal of Minimally Invasive Surgery,2019,01(2):167-169.
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单操作孔胸腔镜前、后亚段联合部分切除术治疗右上肺深部结节6例()

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2019年2期
页码:
167-169
栏目:
经验交流
出版日期:
2019-02-25

文章信息/Info

Title:
Single Utility Port Videoassisted Thoracoscopic S2b+S3a Segmental Resection for Right Upper Pulmonary Deep Nodules: Report of 6 Cases
作者:
沈宇舟 钱俊① 周超 黄平 李文涛**
（上海市胸科医院胸外科，上海200030）
Author(s):
Shen Yuzhou*;  Qian Jun;  Zhou Chao*;  et al.
*Department of Cardiothoracic Surgery, Shanghai Chest Hospital, Shanghai 200030, China
关键词:
肺深部结节; 纯磨玻璃结节
Keywords:
Pulmonary deep nodule; Pure groundglass nodule
文献标志码:
B
摘要:
目的介绍一种单操作孔胸腔镜治疗右上肺前、后亚段交界位置的肺深部结节的方法。 方法2016年10月～2017年2月收治右上肺前、后亚段交界位置的肺深部结节6例，直径9～12 mm，平均11 mm，实施单操作孔胸腔镜手术，全胸腔镜下完成前、后亚段联合部分切除+淋巴结采样。结果6例均成功实施单操作孔胸腔镜手术，手术时间30～52 min，平均41.5 min，术中出血50～100 ml，平均75.0 ml，术后拔管时间2～4 d，拔管当天出院，无严重并发症及死亡。病理诊断原位腺癌4例，微浸润性腺癌2例，均无淋巴结转移，TNM分期，ⅠA1期2例，ⅠA2期4例。术后随访6～10个月，平均7.8月，未发现转移。术前FEV1（2.02±0.40）L，术后3个月降至（1.87±0.37）L（与术前的配对t检验，t=6.167,P=0.002），术后6个月回升至（2.03±0.41）L（与术前的配对t检验，t=0.307,P=0.771）。 结论对右上肺前、后亚段交界位置的肺深部结节，采用单操作孔胸腔镜进行以病灶为中心的肺亚段切除安全、可行，很好地保护了术后肺功能。
Abstract:
ObjectiveTo introduce a safe, feasible and practical method of S2b+S3a segmental resection for the treatment of right upper pulmonary deep nodules. MethodsFrom October 2016 to February 2017, we treated 6 cases of solitary pulmonary deep nodule, 9-12 mm in diameter (mean, 11 mm), with single utility port videoassisted thoracoscopic surgery excision of the S2b+S3a segmental resection and mediastinal lymph node sampling.ResultsAll the 6 cases underwent this operation smoothly. The operative time was 30-52 min (mean, 41.5 min), and the intraoperative bleeding was 50-100 ml (mean, 75.0 ml). The chest tube drainage duration 2-4 days, and the patients were discharged from hospital on the day of extubation. No severe complications or mortality were observed during perioperative period. There were 4 cases of adenocarcioma in situ and 2 cases of micro invasive adenocarcioma, none of the patients having lymph node metastasis. According to the TNM classification, 2 cases were stage ⅠA1 and 4 cases were stage ⅠA2. All the patients were followed up for 6-10 months postoperatively (mean, 7.8 months) without metastasis. The preoperative FEV1 was (2.02±0.40) L, which was decreased to (1.87±0.37) L at 3 postoperative months (t=6167, P=0.002) and to (2.03±0.41) L at the 6 postoperative months (t=0.307, P=0.771).ConclusionThis method of S2b+S3a segmental resection is safe and feasible to treat the right upper pulmonary deep nodules.

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备注/Memo

备注/Memo:
报告基金项目：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.com①（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: 2019-04-28