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中华胸部外科电子杂志 ›› 2023, Vol. 10 ›› Issue (04) : 200 -206. doi: 10.3877/cma.j.issn.2095-8773.2023.04.02

论著

单孔胸腔镜下2枪法在右肺上叶切除术中的运用体会
罗伟, 李易泽, 曹然, 张旭刚, 尹庆, 王昆()   
  1. 650302 安宁,安宁市第一人民医院胸外科
  • 收稿日期:2023-07-27 修回日期:2023-09-11 接受日期:2023-11-06 出版日期:2023-11-28
  • 通信作者: 王昆
  • 基金资助:
    昆明市肺结节肺癌诊治中心(2020-SW(技术)-18); 吴阶平医学基金会临床科研专项(320.6750.2021-17-5); 楚雄医药高等专科学校科学研究基金(2023YYXM02)

Uniportal thoracoscopic right upper lobectomy: a case series of double-stapling technique

Wei Luo, Yize Li, Ran Cao, Xugang Zhang, Qing Yin, Kun Wang()   

  1. Department of Thoracic Surgery, Anning First People’s Hospital, Anning 650302, China
  • Received:2023-07-27 Revised:2023-09-11 Accepted:2023-11-06 Published:2023-11-28
  • Corresponding author: Kun Wang
引用本文:

罗伟, 李易泽, 曹然, 张旭刚, 尹庆, 王昆. 单孔胸腔镜下2枪法在右肺上叶切除术中的运用体会[J]. 中华胸部外科电子杂志, 2023, 10(04): 200-206.

Wei Luo, Yize Li, Ran Cao, Xugang Zhang, Qing Yin, Kun Wang. Uniportal thoracoscopic right upper lobectomy: a case series of double-stapling technique[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2023, 10(04): 200-206.

目的

回顾性分析安宁市第一人民医院单孔胸腔镜下右肺上叶切除术治疗肺癌病例,比较2枪法和传统法在单孔胸腔镜右肺上叶切除术的应用中的差异,总结2枪法手术技术要点,探讨手术效果及推广价值。

方法

纳入安宁市第一人民医院自2021年7月至2023年5月右肺上叶恶性肿瘤,采用单孔胸腔镜下2枪法右肺上叶切除术的患者22例,采用单孔胸腔镜下传统法右肺上叶切除术的患者27例。比较两种手术方法的术中出血量、手术时间、胸腔引流管带管时间等的差异。

结果

2枪法组共22例患者完成手术,年龄(58.00±9.38)岁,其中男16人,女6人。手术操作时间(84.86±15.81)min,出血量(73.86±21.98)mL,胸腔引流管带管时间2.00(1.00,2.00) d,术后住院时间5.00(4.75,6.00) d。传统法组共有27例患者完成手术,年龄(58.46±8.63)岁,其中男13人,女14人。手术操作时间(93.55±13.43)min,出血量(85.34±20.22)mL,胸腔引流管带管时间2.00(1.00,3.00) d,术后住院时间5.00(4.50,6.00) d。2枪法组手术操作时间较传统法组短,差异有统计学意义(P<0.05)。

结论

单孔胸腔镜下2枪法右肺上叶切除术与传统法相比,手术操作时间更短,同样可以达到根治术效果,2枪法简化了手术流程,简单易行,安全可靠,同时减轻患者经济负担,是一种使患者受益的、安全可靠的术式。

Objective

To retrospectively analyze the patients who underwent uniportal thoracoscopic right upper lobectomy using double-stapling vs traditional technique at Anning First People's Hospital Affiliated to Kunming University of Science and Technology. Compare the differences between the double-stapling technique and traditional technique in the application of uniportal thoracoscopic right upper lobe resection, summarize the key points of the double-stapling surgical technique, and explore the surgical results and promotional value.

Methods

Forty-nine patients from July 2021 to May 2023 were consecutively enrolled at Anning First People's Hospital. A total of 22 patients underwent uniportal thoracoscopic two-stapler resection of the right upper lobe. A total of 27 patients underwent uniportal thoracoscopic right upper lobectomy using traditional methods. The outcome measures were operative time, intraoperative bleeding, drainage tube duration and postoperative hospital stay.

Results

For the double-stapling technique group, 22 patients (16 males, 6 females) were enrolled. The median age was (58.00±9.38) years old. There were no cases converted to thoracotomy. The mean operative duration was (84.86±15.81) min, the mean intraoperative blood loss was (73.86±21.98) mL, the mean drainage tube duration was 2.00 (1.00, 2.00) days, and the mean postoperative hospital stay was 5.00 (4.75, 6.00) days. For the traditional technique group, 27 patients (13 males, 14 females) were enrolled. The median age was (58.46±8.63) years old. The mean operative duration was (93.55±13.43) min, the mean intraoperative blood loss was (85.34±20.22) mL, the mean drainage tube duration was 2.00 (1.00, 3.00) days, and the mean postoperative hospital stay was 5.00 (4.50, 6.00) days. The shorter surgical operative time for the double-stapling technique was statistically significant (P<0.05) .

Conclusions

Compared to traditional techniques, uniportal thoracoscopic double-stapling technique for right upper lobectomy has a shorter operative time while also achieving a curative effect. The operative process is simple, easy to perform, safe, reliable, and benefits patients while reducing their economic burden.

表1 两组患者资料比较
图1 患者体位
图2 术者及助手位于患者同侧
图3 术者及助手位于患者不同侧
图4 手术器械
图5 置入切口保护套
图6 清扫第7组淋巴结
图7 吻合切断右肺上叶支气管
图8 切断右肺上叶血管
图9 取出肺叶标本
图10 清扫2、4组淋巴结
图11 观察残端
图12 肋间神经阻滞
图13 置管引流
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