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目的 探讨放射性核素胶体32p在胸壁小切口辅助电视胸腔镜肺叶切除治疗Ⅱ期肺癌中应用的可能性。rrrrrrrrn方法 在双腔管气管插管常规全麻下实施电视胸腔镜手术。术中健侧肺单肺通气，第4或第5肋间8～10 cm切口，辅助胸腔镜下rrrrrrrrn肺叶切除及清扫淋巴结，对手术中认为淋巴结清扫不彻底及淋巴结转移区域，局部注射放射性核素胶体32pMBq(5～10mCi)。rrrrrrrrn结果 29例病人在VEMAST下完成肺叶切除，1例因肺动脉肿瘤包裹，术中出血改在常规开胸下完成肺叶切除，另1例因肺动脉无rrrrrrrrn法与肿瘤分离而中转手术，无手术死亡，无严重并发症，无放射性核素胶体32p不良反应。rrrrrrrrn结论 胸壁小切口辅助电视胸腔镜肺叶切除治疗Ⅱ期肺癌时，对手术中认为切除不满意或淋巴结转移处施行了放射性核素治疗。rrrrrrrrn小切口辅助VATS下肺叶切除、使用放射性核素胶体32p有选择的治疗Ⅱ期肺癌是一种安全有效的治疗方法。
Objective To investigate the possibility of application of radionuclide colloid 32p in the treatment of stage Ⅱ lung cancer with small chest thoracotomy assisted video-assisted thoracoscopic lobectomy. Methods The video-assisted thoracoscopic surgery was performed under general anesthesia with double-lumen endotracheal intubation. Intraoperative lung contralateral lung ventilation, the 4th or 5th intercostal 8 ~ 10 cm incision, assisted thoracoscopic lobectomy and lymph node dissection, Considering the lack of thorough lymphadenectomy and lymph node metastasis, 32pMBq (5 ~ 10mCi) of radionuclide colloid was injected locally. RESULTS: Twenty-nine patients underwent lobectomy under VEMAST and one patient was enrolled due to pulmonary tumor. The intraoperative bleeding was changed to open lobectomy under conventional thoracotomy. One case had no surgical death, no serious complications, and no adverse reactions of radionuclide colloid 32p due to pulmonary artery separation and tumor separation. Conclusions A small chest thoracotomy assisted video-assisted thoracoscopic lobectomy in the treatment of stage II lung cancer was performed when radionuclide was not satisfactory for surgery or lymph node metastasis treatment. Small incision assisted VATS under lobectomy, the use of radionuclide colloid 32p selective treatment of stage Ⅱ lung cancer is a safe and effective treatment.