单操作孔胸腔镜手术治疗胸部疾病121例临床分析

目的 探讨单操作孔胸腔镜手术治疗胸外科疾病的临床应用价值及效果分析.方法 选择我科采用单操作孔胸腔镜手术121例,其中包括气胸及肺大疱18例,肺良性肿瘤（肺炎性假瘤、肺硬化性血管瘤、肺错构瘤）34例,肺异物1例,肺结核球7例,肺恶性肿瘤（原发及转移）30例,纵隔肿物21例,食管异物伴穿孔后纵隔感染行纵隔切开减压引流2例,胸膜活检8例.术前明确诊断21例,其余均经术后病理明确诊断.手术方式以肺楔形切除及局部切除为主,切口均为1 个操作孔和1个观察孔.结果全组患者无围手术期死亡和重要并发症.全部病例手术时间10～110 min,平均（41±177;10.73）min;术中出血10-200 mL,平均（76±177;13.57）mL;术后住院天数3～9 d,平均（5±177;1.36）d.结论 单操作孔电视胸腔镜手术治疗常见不复杂的胸外科疾病安全、可靠,值得在临床上进一步探索及推广.

Uniportal video-assisted thoracoscopic surgery for 121 patients with thoracic diseases

Objective To explore the method and effect of uniportal video-assisted thoracoseopic surgery （VATS） for the treatment of thoracic diseases. Methods From Jan 2011 to Sep 2012, 121 patients with thoracic diseases were treated by single working pore VATS in the department of thoracic surgery of Fujian Provincial Hospital. Their diseases included different lesions, such as pneumothorax （inflammatory pseudotumor, hamartoma, lymphangiomyomatosis）, lung tuberculoma, lung carcinoma, mediastinal mass and the foreign matters in the lung, etc. Twenty-one patients had definite diagnosis before their operation, and the others had their final diagnosis by postoperative pathology examination. All the resections were carried out by pure thoracoscopic procedures with two ports, one working pore and one observing pore. Limited lung resection and tumor resection was major operation performed. Results For limited lung resection patients, the average operation time was 10-110 min （41±10.73） min, and the average blood loss was 0-200 mL （76±13.57） niL. No patient needed intraoperative blood transfusion. The average postoperative length of stay was 3-9 days （5 ± 1.36） days. No perioperative death or severe compli- cations were observed in present series. Conclusion Uniportal VATS is a safe and efficient procedure with good patient recover- y. It is a method of choice for selected patients with thoracic diseases.