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目的探讨单孔电视胸腔镜(video-assisted thoracoscopic surgery,VATS)肺切除术的可行性和安全性。方法回顾性分析2015年8月—2016年8月,在海军总医院胸外科实施单孔VATS肺切除术168例,对患者的临床资料、手术方式和外科结果进行分析。结果完成单孔VATS肺切除术150例,手术时间35~340(125.7±61.5)min,出血量10~800 mL;术后胸管留置时间0~10(3.3±2.5)d;术后住院时间2~35(5.6±3.4)d。中转为多孔胸腔镜或胸腔镜辅助小切口手术18例。全组无围手术期死亡病例。根据术后并发症Clavien-Dindo系统分级标准,Ⅱ级6例、Ⅲa级10例、Ⅲb级1例、Ⅳ级2例。结论单孔VATS肺切除术是一种安全、可行的手术方法,具有创伤小、疼痛轻、恢复快的优点,值得在临床进一步推广应用。
Objective To investigate the feasibility and safety of video-assisted thoracoscopic surgery (VATS) pneumonectomy. Methods A retrospective analysis of 168 cases of VATS pneumonectomy in the Department of Thoracic Surgery, Navy General Hospital from August 2015 to August 2016 was conducted. The clinical data, surgical methods and surgical results of the patients were analyzed. Results One-hole VATS pneumonectomy was performed in 150 cases. The operative time ranged from 35 to 340 (125.7 ± 61.5) min and the bleeding volume was 10 to 800 mL. The postoperative chest tube placement time ranged from 0 to 10 (3.3 ± 2.5) days. The postoperative hospital stay 2 ~ 35 (5.6 ± 3.4) d. Transferred to the porous thoracoscope or thoracoscopic assisted small incision in 18 cases. The whole group without perioperative deaths. According to Clavien-Dindo classification system, 6 cases were grade Ⅱ, 10 cases were Ⅲa, 1 case was Ⅲb and 2 cases were Ⅳ. Conclusion One-hole VATS pneumonectomy is a safe and feasible surgical method, which has the advantages of less trauma, less pain and faster recovery. It is worth further clinical application.