Application of single-port thoracoscopy combined with three-dimensional CT bronchography and angiography in anatomical segmentectomy of lungs
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摘要:目的 探讨单孔胸腔镜联合三维血管支气管CT成像（3D-CTBA）在解剖性肺段切除中的应用价值。方法 选取行单孔胸腔镜解剖性肺段切除术的46例肺部小结节患者为研究对象，对其临床资料进行回顾性分析。结果 所有患者术前均行3D-CTBA，均在单孔胸腔镜下行肺段切除术，无中转开胸，无扩大肺叶切除，无围术期死亡。手术时间为（139.3±32.5）min，术中出血量为（84.5±45.3）mL，术后胸管拔管时间为（5.5±1.3）d，术后住院时间为（7.1±2.8）d，淋巴结清扫数目为（10.2±3.4）枚。术后病理为原发性肺腺癌39例，转移性癌3例，肉芽肿4例。术后2例肺漏气大于5 d，经持续引流后好转；2例肺部感染，抗感染治疗后好转；3例心律失常。结论 单孔胸腔镜联合3D-CTBA解剖性肺段切除术安全性、可行性较好，有利于患者快速康复。
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关键词:
- 单孔 /
- 电视胸腔镜 /
- 三维血管支气管CT成像 /
- 肺段切除
Abstract:Objective To investigate the application value of single-port thoracoscopy combined with three-dimensional CT bronchography and angiography (3D-CTBA) in anatomical segmentectomy of lungs.Methods A total of 46 patients with pulmonary nodules who underwent single-port thoracoscopic anatomical segmentectomy and their clinical data were retrospectively analyzed.Results All patients underwent 3D-CTBA before operation, and segmentectomy was performed under single-port thoracoscopy without thoracotomy, extended lobectomy and perioperative death.The operative time was (139.3±32.5) min, the intraoperative blood loss was (84.5±45.3) mL, the postoperative chest tube extubation time was (5.5±1.3) days, the postoperative hospital stay was (7.1±2.8) days and the number of lymph nodes dissected was (10.2±3.4).Postoperative pathology showed primary lung adenocarcinoma in 39 cases, metastatic carcinoma in 3 cases and granuloma in 4 cases. After operation, two patients had pulmonary air leakage more than 5 days, which was improved after continuous drainage; two cases had pulmonary infection, and were improved after anti-infection treatment; arrhythmia occurred in 3 cases.Conclusion Single-port thoracoscopy combined with 3D-CTBA anatomical segmentectomy is safe and feasible, which is conducive to the rapid recovery of patients. -
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表 1 单孔胸腔镜肺段切除
左侧切除肺段 n 右侧切除肺段 n S1~3 4 S1 5 S1~2 3 S2 3 S4~5 4 S1~2 5 S6 5 S3 3 S8 3 S6 4 S9 2 S8 3 - - S9~10 2 S1: 尖段; S2: 后段; S1~2: 尖后段;
S3: 前段; S1~3: 固有段; S4~5: 舌段;
S6: 背段; S8: 前基底段; S9: 外基底段;
S9~10: 外后基底段。
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