目的 總結(jié) 11例胸腔鏡隱蔽切口手術(shù)的治療經(jīng)驗(yàn),探討胸腔鏡隱蔽切口手術(shù)的可行性和安全性。方法 回顧性分析 2011年 9~ 11月四川大學(xué)華西醫(yī)院 11例行隱蔽切口胸腔鏡手術(shù)患者的臨床資料,其中男 2例,女 9例;年齡 34.0(16~ 59)歲。術(shù)前臨床診斷重癥肌無(wú)力 4例,胸腺瘤 4例,胸腺囊腫 2例,手汗癥 1例。胸腔鏡胸腺擴(kuò)大切除( extended thoracoscopic thymectomy,ETT)10例,胸腔鏡交感神經(jīng)干切斷( endoscopic thoracic sympathectomy, ETS)1例。結(jié)果 全組患者均順利完成胸腔鏡手術(shù),無(wú)術(shù)中、術(shù)后并發(fā)癥發(fā)生。手術(shù)時(shí)間 70.5(30~ 105)min,術(shù)中出血量均< 5 ml,術(shù)后胸腔引流管留置時(shí)間均< 48 h,胸腔引流量 55.5(30~ 80)ml,術(shù)后住院時(shí)間 3.5(2~ 4)d,切口創(chuàng)傷小、隱蔽而美觀。 10例行 ETT患者術(shù)后病理診斷胸腺增生 4例,胸腺瘤 4例,胸腺囊腫 2例。結(jié)論 隱蔽切口胸腔鏡手術(shù)安全可行,可滿足患者對(duì)切口隱蔽美觀的要求。
引用本文: 張真銘,王允,宋宇. 胸腔鏡隱蔽切口手術(shù)11例. 中國(guó)胸心血管外科臨床雜志, 2012, 19(3): 283-285. doi: 復(fù)制
版權(quán)信息: ?四川大學(xué)華西醫(yī)院華西期刊社《中國(guó)胸心血管外科臨床雜志》版權(quán)所有,未經(jīng)授權(quán)不得轉(zhuǎn)載、改編
1. | 劉倫旭, 車國(guó)衛(wèi), 蒲強(qiáng), 等. 單向式全胸腔鏡肺葉切除術(shù). 中華胸心血管外科雜志, 2008, 24 (3):156-158. |
2. | 陳應(yīng)泰, 王俊, 劉軍, 等. 縱隔腫瘤的胸腔鏡手術(shù)治療. 中國(guó)微創(chuàng)外科雜志, 2002, 2 (5):283-285. |
3. | Sugarbaker DJ. Thoracoscopy in the management of anterior mediastinal masses. Ann Thorac Surg, 1993, 56 (3):653-656. |
4. | Roviaro G, Rebuffat C, Varoli F, et al. Videothoracoscopic excision of mediastinal masses:indications and technique. Ann Thorac Surg, 1994, 58 (6):1679-1683. |
5. | Kux E. The endoscopic approach to the vegetative nervous system and its therapeutic possibilities;especially in duodenal ulcer, angina pectoris,hypertension and diabetes. Dis Chest, 1951, 20 (2):139-147. |
6. | 涂遠(yuǎn)榮, 李旭, 林敏, 等. 胸腔鏡下胸交感神經(jīng)干切斷術(shù)的臨床研究(附 20例報(bào)告) . 中國(guó)微創(chuàng)外科雜志, 2005, 5 (12):993-994. |
7. | Port JL, Ginsberg RJ. Surgery for thymoma. Chest Surg Clin N Am, 2001, 11 (2):421-437. |
8. | Kondo K, Monden Y. Thymoma and myasthenia gravis:a clinical study of 1,089 patients from Japan. Ann Thorac Surg, 2005, 79 (1):219-224. |
9. | 張?jiān)品澹?馬山, 李建業(yè), 等. 電視胸腔鏡胸腺切除術(shù)與開放性手術(shù)的對(duì)比分析. 中華外科雜志, 2009, 47 (5):366-368. |
10. | Shiono H, Kadota Y, Hayashi A, et al. Comparison of outcomes after extended thymectomy for myasthenia gravis:bilateral thoracoscopic approach versus sternotomy. Surg Laparosc Endosc Percutan Tech, 2009, 19 (6):424-427. |
11. | 楊劼, 譚家駒. 手汗癥的內(nèi)鏡手術(shù)方法. 中國(guó)內(nèi)鏡雜志, 2003, 9 (10):51-52. |
12. | Toker A, Tanju S, Ziyade S, et al. Early outcomes of video-assisted thoracoscopic resection of thymus in 181 patients with myasthenia gravis:who are the candidates for the next morning discharge? Interact Cardiovasc Thorac Surg, 2009, 9 (6):995-998. |
13. | Toker A, Erus S, Ozkan B, et al. Does a relationship exist between the number of thoracoscopic thymectomies performed and the learning curve for thoracoscopic resection of thymoma in patients with myasthenia gravis?Interact Cardiovasc Thorac Surg, 2011, 12 (2):152-155. |
14. | Pennathur A, Qureshi I, Schuchert MJ, et al. Comparison of surgical techniques for early-stage thymoma:feasibility of minimally invasive thymectomy and comparison with open resection. J Thorac Cardiovasc Surg, 2011, 141 (3):694-701. |
15. | Pompeo E, Tacconi F, Massa R, et al. Long-term outcome of thoracoscopic extended thymectomy for nonthymomatous myasthenia gravis. Eur J Cardiothorac Surg, 2009, 36 (1):164-169. |
- 1. 劉倫旭, 車國(guó)衛(wèi), 蒲強(qiáng), 等. 單向式全胸腔鏡肺葉切除術(shù). 中華胸心血管外科雜志, 2008, 24 (3):156-158.
- 2. 陳應(yīng)泰, 王俊, 劉軍, 等. 縱隔腫瘤的胸腔鏡手術(shù)治療. 中國(guó)微創(chuàng)外科雜志, 2002, 2 (5):283-285.
- 3. Sugarbaker DJ. Thoracoscopy in the management of anterior mediastinal masses. Ann Thorac Surg, 1993, 56 (3):653-656.
- 4. Roviaro G, Rebuffat C, Varoli F, et al. Videothoracoscopic excision of mediastinal masses:indications and technique. Ann Thorac Surg, 1994, 58 (6):1679-1683.
- 5. Kux E. The endoscopic approach to the vegetative nervous system and its therapeutic possibilities;especially in duodenal ulcer, angina pectoris,hypertension and diabetes. Dis Chest, 1951, 20 (2):139-147.
- 6. 涂遠(yuǎn)榮, 李旭, 林敏, 等. 胸腔鏡下胸交感神經(jīng)干切斷術(shù)的臨床研究(附 20例報(bào)告) . 中國(guó)微創(chuàng)外科雜志, 2005, 5 (12):993-994.
- 7. Port JL, Ginsberg RJ. Surgery for thymoma. Chest Surg Clin N Am, 2001, 11 (2):421-437.
- 8. Kondo K, Monden Y. Thymoma and myasthenia gravis:a clinical study of 1,089 patients from Japan. Ann Thorac Surg, 2005, 79 (1):219-224.
- 9. 張?jiān)品澹?馬山, 李建業(yè), 等. 電視胸腔鏡胸腺切除術(shù)與開放性手術(shù)的對(duì)比分析. 中華外科雜志, 2009, 47 (5):366-368.
- 10. Shiono H, Kadota Y, Hayashi A, et al. Comparison of outcomes after extended thymectomy for myasthenia gravis:bilateral thoracoscopic approach versus sternotomy. Surg Laparosc Endosc Percutan Tech, 2009, 19 (6):424-427.
- 11. 楊劼, 譚家駒. 手汗癥的內(nèi)鏡手術(shù)方法. 中國(guó)內(nèi)鏡雜志, 2003, 9 (10):51-52.
- 12. Toker A, Tanju S, Ziyade S, et al. Early outcomes of video-assisted thoracoscopic resection of thymus in 181 patients with myasthenia gravis:who are the candidates for the next morning discharge? Interact Cardiovasc Thorac Surg, 2009, 9 (6):995-998.
- 13. Toker A, Erus S, Ozkan B, et al. Does a relationship exist between the number of thoracoscopic thymectomies performed and the learning curve for thoracoscopic resection of thymoma in patients with myasthenia gravis?Interact Cardiovasc Thorac Surg, 2011, 12 (2):152-155.
- 14. Pennathur A, Qureshi I, Schuchert MJ, et al. Comparison of surgical techniques for early-stage thymoma:feasibility of minimally invasive thymectomy and comparison with open resection. J Thorac Cardiovasc Surg, 2011, 141 (3):694-701.
- 15. Pompeo E, Tacconi F, Massa R, et al. Long-term outcome of thoracoscopic extended thymectomy for nonthymomatous myasthenia gravis. Eur J Cardiothorac Surg, 2009, 36 (1):164-169.