探讨单孔电视辅助胸腔镜手术在肺叶切除中的临床价值。

2014年4月至2015年3月，对118例术前疑诊或诊断为Ⅰ～Ⅱ期的周围型肺癌(T₁N₀M₀～T₃N₀M₀)或良性病变的患者在全麻下行双腔气管插管后，于腋前线第5肋间作长约4 cm的切口为操作孔，未用器械撑开肋骨，同一切口置入胸腔镜，行单孔电视辅助胸腔镜下肺叶切除术。

118例患者均经肋间入路成功完成单孔胸腔镜下肺叶切除术，无中转开胸或小切口辅助切除，无手术死亡。其中23例左肺上叶切除，11例左肺下叶切除，49例右肺上叶切除，12例右肺中叶切除，23例右肺下叶切除。手术时间(224.8±6.3)min，术中出血量(93.2±5.8)ml，无术中输血。术后并发肺炎9例，漏气1例，肺气肿1例，乳糜胸4例，下肢深静脉血栓1例，均经对症保守治疗后而好转。

单孔胸腔镜下肺叶切除术安全、可行。

To explore the clinical value of single-port video-assisted thoracoscopic surgery in the treatment of lobectomy.

Between April 2014 and March 2015, single-port video-assisted thoracoscopic surgery for lobectomy was performed among 118 patients with preoperative diagnosis or consideration as Ⅰ-Ⅱstage of peripheral lung cancer(T₁N₀M₀-T₃N₀M₀) or benign lesion.The operating port was made at the fifth intercostal space on the anterior axillary line with a length of 4 cm without using the equipment to spread ribs in general endotracheal anesthesia of double lumen tube intubation with rocuronium.The observation port was as same as the operating port.

Single-port video-assisted thoracoscopic surgery was successfully completed in 118 cases. No patient was converted to open thoracotomy or video-assisted minithoracotomy, and no died during the operative period. Superior lobe of left lung resection was done in 23 cases, inferior lobe of left lung in 11 cases, superior lobe of right lung in 49 cases, middle lobe of right lung in 12 cases, and inferior lobe of right lung in 23 cases. The mean operation time was (224.8±6.3)min, and the mean volume of peri-operative bleeding was (93.2±5.8) ml. There was no blood transfusion during operation.Postoperative pulmonary infection occurred in 9 cases, air leakage in 1 case, emphysema in 1 case, chylothorax in 4 cases, and deep venous thrombosis in 4 cases, all of which were cured by symptomatic or conservative treatment.

Single-port video-assisted thoracoscopic surgery for lobectomy is safe and feasible.