中国科学技术大学附属第一医院//安徽省立医院胸外科,安徽 合肥 230001
徐广文,主治医师,E-mail: Xu_guangwen@sina.com
纸质出版日期:2022-11-20,
收稿日期:2022-04-05,
扫 描 看 全 文
徐广文,解明然,王高祥等.同期双侧单孔胸腔镜手术在双肺多发结节治疗中的应用[J].中山大学学报(医学科学版),2022,43(06):1012-1019.
XU Guang-wen,XIE Ming-ran,WANG Gao-xiang,et al.Simultaneous Bilateral Pulmonary Resections by Uniportal Video-assisted Thoracic Surgery for Bilateral Multiple Pulmonary Nodules[J].Journal of Sun Yat-sen University(Medical Sciences),2022,43(06):1012-1019.
徐广文,解明然,王高祥等.同期双侧单孔胸腔镜手术在双肺多发结节治疗中的应用[J].中山大学学报(医学科学版),2022,43(06):1012-1019. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2022.0617.
XU Guang-wen,XIE Ming-ran,WANG Gao-xiang,et al.Simultaneous Bilateral Pulmonary Resections by Uniportal Video-assisted Thoracic Surgery for Bilateral Multiple Pulmonary Nodules[J].Journal of Sun Yat-sen University(Medical Sciences),2022,43(06):1012-1019. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2022.0617.
目的
2
探讨同期双侧单孔胸腔镜手术在双肺多发结节治疗中的应用价值。
方法
2
回顾性收集2020年8月至2021年8月期间在中国科学技术大学附属第一医院胸外科行同期双侧单孔胸腔镜手术的40例患者的临床病理资料和围手术期资料。男性12例,女性28例;平均年龄(52±8.8)岁,中位数为[52.5(47.25~58)]岁。
结果
2
40例患者共切除107个肺结节,85个为恶性。病理诊断有30例多原发肺癌,6例单原发肺癌。手术出血量(48.87±19.29)mL,中位数为[40(30~67.5)] mL,手术时间(147.70±54.24) min,中位数为[145(113.5~170)] min,淋巴结清扫数6.20±9.13,中位数为[3(0~12)]个,术后首日NRS评分5.08±2.23。胸腔引流总量为(375.95±243.69) mL,中位数为[292.5(215~517.5)] mL。平均胸引管留置时间为(3.38±1.49) min,中位数为[3(3~4)] d,术后平均住院时间为(4.08±1.81) d,中位数为[4(3~5)] d。围手术期无死亡病例,并发症包括2例切口感染,3例一过性房颤,1例肺持续漏气,1例咯血,所有患者均顺利出院。
结论
2
同期双侧单孔胸腔镜肺手术治疗双肺多发结节是安全可行的,对于心肺功能良好,无严重基础疾病的有手术指征的双肺结节患者可作为首选治疗方案。
Objective
2
To explore the application of simultaneous bilateral uniportal video-assisted thoracic surgery in the treatment of bilateral multiple pulmonary nodules.
Methods
2
The clinical and pathological characteristics , and perioperative data were analyzed in thoracic surgery from August 2021 to August 2021 at Department of Thoracic Surgery, the First Affiliated Hospital of University of Science and Technology of China. During the study period, 40 patients were included in the study, of which 12 were male, 28 were female, the average age was (52±8.8) [52.5(47.25~58)] years.
Results
2
A total of 107 nodules were resected, with 85 malignancy nodules, including 30 patients with bilateral primary lung cancer, 6 patients with primary lung cancer on one side. All patients underwent bilateral uniportal video-assisted thoracoscopic surgery (Uni-portal VATS), the average intraoperative blood loss was (48.87±19.29) [40(30~67.5)] mL, the average operation time was (147.70±54.24) [145(113.5~170)] min, the average number of resected lymph nodes was (6.20±9.13) [3(0~12)],the average NRS score in the 1
th
postoperative day was (5.08±2.23), the average pleural drainage was (375.95±243.69) [292.5(215.0~517.5)] mL. the average thoracic drainage time was(3.38±1.49) [3(3~4)] days, and the average postoperative hospital stay was (4.08±1.81) [4(3~5)] days. Postoperative complications including: 2 cases of infection, 3 cases of atrial fibrillation, 1 case of hemoptysis for more than 1 week and 1case of persistent air leakage for more than 3 days. All of them improved after treatment, and there were no serious complications and deaths in perioperative period.
Conclusion
2
Simultaneous bilateral pulmonary resections via uniportal VATS is a safe and feasible minimally invasive procedure for patients with bilateral multiple pulmonary nodules.
单孔胸腔镜手术同期手术双肺多发结节多原发肺癌
uniportal video-assisted thoracoscopic surgerysimultaneousbilateral multiple pulmonary nodulesmultiple primary lung cancers
Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2018, 68(6): 394-424.
郑荣寿,孙可欣,张思维,等. 2015年中国恶性肿瘤流行情况分析[J]. 中华肿瘤杂志,2019, 41(1): 19-28.
Zheng RS, Sun KX, Zhang SW, et al. Report of cancer epidemiology in China, 2015[J]. Chin J Oncol, 2019, 41(1): 19-28.
张华, 郭坚溪, 肖伟俅, 等. CT引导下肺结节定位针临床运用的中期研究[J]. 影像诊断与介入放射学, 2021, 30(5): 364-370.
Zhang H, Guo JX, Xiao WQ, et al. Mid term study on clinical application of CT guided pulmonary nodule locating needle[J]. Diagn Imag & Interv Radiol, 2021, 30(5): 364-370.
Zhang Y, Fu F, Chen H. Management of ground-glass opacities in the lung cancer spectrum[J]. Ann Thorac Surg,2020, 110(6): 1796-1804.
Li J, Qiu B, Scarci M, et al. Uniportal video-assisted thoracic surgery could reduce postoperative thorax drainage for lung cancer patients[J]. Thoracic Cancer, 2019, 10(6): 1334-1339.
Travis WD, Asamura H, Bankier AA, et al.The IASLC lung cancer staging project: proposals for coding T categories for sub-solid nodules and assessment of tumor size in part-solid tumors in the forthcoming eighth edition of the TNM classifcation of lung cancer[J]. J Thorac Oncol, 2016, 11(8): 1204-1223.
Martini N, Melamed MR. Multiple primary lung cancers[J]. J Thorac Cardiovasc Surg, 1975, 70(4): 606-612.
Schreuder A, Prokop M, Scholten ET, et al. CT-detected subsolid nodules: a predictor of lung cancer development at another location?[J]. Cancers (Basel), 2021, 13(11): 2812.
Nakada T, Kuroda H. Narrative review of optimal prognostic radiological tools using computed tomography for T1N0-staged non-small cell lung cancer[J]. J Thorac Dis, 2021, 13(5): 3171-3181.
Lin B, Wang R, Chen L, et al.Should resection extent be decided by total lesion size or solid component size in ground glass opacity-containing lung adenocarcinoma?[J]. Transl Lung Cancer Res, 2021, 10(6): 2487-2499.
Desseroit MC, Visvikis D, Tixier F, et al. Development of a nomogram combining clinical staging with(18)F‐FDG PET/CT image features in non‐small‐cell lung cancer stageⅠ‐Ⅲ[J]. EurJ Nucl Med Mol Imaging, 2016, 43(8): 1477‐1485.
郭坚溪 ,张华, 肖伟俅, 等. 肺结节定位针在肺小结节术前定位的初步临床研究[J]. 影像诊断与介入放射学, 2020, 29(5): 349-355.
Guo JX, Zhang H, Xiao WQ, et al. Preliminary clinical study on preoperative localization of pulmonary nodules with pulmonary nodule locating needle[J]. Diagn Imag & Interv Radiol, 2020, 29(5): 349-355.
Chen KN. The diagnosis and treatment of lung cancer presented as ground-glass nodule[J]. Gen Thorac Cardiovasc Surg, 2020, 68(7): 697-702.
王芝馀, 陶润仪, 冯锦腾, 等. 多发肺结节的外科治疗进展[J/CD]. 中华胸部外科电子杂志, 2021, 8(2): 108-112.
Wang ZY, Tao RY, Feng JT, et al. Progress in surgical treatment of multiple pulmonary nodules[J/CD]. Chin J Thorac Surg(Electronic Edition), 2021, 8(2): 108-112.
王高祥, 熊燃, 吴汉然, 等. 单孔与三孔胸腔镜治疗非小细胞肺癌患者近期结果对比分析[J]. 中国肺癌杂志, 2018, 21(12): 896-901.
Wang GX, Xiong R, Wu HR, et al. Short-term outcome of uniportal and three portal video-assisted thoracic surgery for patients with non-small cell lung cancer[J]. Zhongguo Fei Ai Za Zhi. 2018, 21(12): 896-901.
吴汉然, 李彩伟, 熊燃, 等.单孔胸腔镜肺部手术淋巴结清扫范围及中转率分析[J].中华胸心血管外科杂志, 2018, 34(9): 513-517.
Wu HR, Li CW, Xiong R.et al. A retrospective study of lymphadenectomy and conversive rate in uniportal video-assisted thoracoscopic pneumonectomy[J]. Chin J thoracic cardiol, 2018, 34(9): 513-517.
李彩伟, 徐美青, 徐广文, 等. 单孔与三孔胸腔镜肺部手术后急慢性疼痛的对比研究[J]. 中国肺癌杂志, 2018, 21(4): 279-284.
Li CW, Xu MY, Xu GW, et al. A comparative study of acute and chronic pain between single port and triple port video-assisted thoracic surgery for lung cancer[J]. Zhongguo Fei Ai Za Zhi, 2018, 21(4): 279-284.
Sesti J, Donington JS. Sub-lobar resection: ongoing controversy for treatment for stage I non-small cell lung cancer[J]. Thorac Surg Clin, 2016, 26(3): 251-259.
Lin S, Yang C, Guo X, et al.Simultaneous Uniportal video-assisted thoracic surgery of bilateral pulmonary nodules[J]. J Cardiothorac Surg, 2021, 16(1):42.
Huang C, Sun Y, Wu Q, et al. Simultaneous bilateral pulmonary resection via single-utility port VATS for multiple pulmonary nodules: a single-center experience of 16 cases[J]. Thorac Cancer, 2021, 12(4): 525-533.
Zheng H, Peng Q, Xie D, et al. Simultaneous bilateral thoracoscopic lobectomy for synchronous bilateral multiple primary lung cancer-single center experience[J]. J Thorac Dis, 2021, 13(3): 1717-1727.
张正华, 吴杲, 徐美青. 单孔胸腔镜结合负压球细管引流在肺大疱切除术快速康复中的应用[J]. 中华胸心血管外科杂志, 2017, 33(3): 183-184.
Zhang ZH, Wu G, Xu MQ, Application of single-site video-assisted thoracoscopy combined with negtive drainage tubule in faster rehabilitation after resection of pulmonary bubble[J]. Chin J Thorac Cardiovasc Surg, 2017, 33(3): 183-184.
Romaszko AM, Doboszynska A. Multiple primary lung cancer: a literature review[J]. Adv Clin Exp Med, 2018, 27(5): 725-730.
Detterbeck FC, Jones DR, Kernstine KH, et al. Special treatment issues[J]. Chest J, 2003, 123(1_suppl): 244S-258S.
孔雁, 荆丽, 王玉栋, 等. 多学科诊治肺多原发癌1例[J]. 广东医学, 2015, 36(16): 2608.
kong Y, Jing L, Wang YD, et al. Multidisciplinary diagnosis and treatment of multiple primary lung cancer: a case report[J]. J Guangdong Med, 2015, 36(16): 2608.
Ung KA, Campbell BA, Duplan D, et al. Impact of the lung oncology multidisciplinary team meetings on the management of patients with cancer[J]. Asia Pac J Clin Oncol, 2016, 12(2): e298-e304.
Chua GWY, Chua KLM. Which patients benefit most from stereotactic body radiotherapy or surgery in medically operable non-small cell lung cancer? an in-depth look at patient characteristics on both sides of the debate[J]. Thorac Cancer, 2019, 10(10): 1857-1867
Schneider BJ, Daly ME, Kennedy EB, et al. Stereotactic body radiotherapy for early-stage non-small-cell lung cancer: American Society of Clinical Oncology endorsement of the American Society for Radiation Oncology evidence-based guideline[J]. J Clin Oncol, 2018, 36(7): 710-719.
0
浏览量
0
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构