目的 探讨 2 cm 单孔胸腔镜肺叶切除术的可行性及安全性。 方法 回顾性分析 2016 年 3～8 月我院胸外科行 2 cm 单孔胸腔镜下解剖性肺叶切除术 8 例肺癌患者的临床资料，其中男 5 例、女 3 例，年龄41～75（58.5±10.1）岁。在腋前线第 3 肋间做 2 cm 切口置入胸腔镜及手术器械行解剖性肺叶切除术。 结果 8 例均顺利完成手术，无中转开胸。手术时间（191.6±41.9）min，术中出血量（186.3±175.0）ml，术后胸腔引流时间（4.5±1.7）d，术后住院时间（5.5±1.7）d。术后病理均为 ⅠA 期非小细胞肺癌。 结论 2 cm 单孔胸腔镜下解剖性肺叶切除术治疗早期肺癌安全、可行，减小了胸腔镜手术对患者的创伤，其进一步的推广应用需更多研究的支持。
Objective To explore the safety and feasibility of preferential manual bronchoplasty in single-port video-assisted thoracoscopic surgery (VATS) upper lobectomy. MethodsThe clinical data of 457 patients with non-small cell lung cancer who underwent single-port VATS lobectomy in the Department of Thoracic Surgery of Peking University First Hospital from March 2020 to March 2022 were retrospectively analyzed. The patients were divided into a preferential manual bronchoplasty group and a traditional single-port VATS lobectomy group with a 1 : 1 propensity score matching for further research. Results A total of 204 patients were matched, and there were 102 patients in each group. There were 50 males and 52 females aged 62.2±10.1 years in the preferential bronchoplasty group, and 49 males and 53 females aged 61.2±10.7 years in the traditional single-port VATS group. The preferential bronchoplasty group had shorter surgical time (154.4±37.0 min vs. 221.2±68.9 min, P<0.01), less bleeding (66.5±116.9 mL vs. 288.6±754.5 mL, P=0.02), more lymph node dissection (19.8±7.5 vs. 15.2±4.7, P<0.01), and a lower conversion rate to multi-port or open surgery (2.3% vs. 13.8%, P=0.04) in left upper lobe resection. In the right upper lobe resection surgery, there was no statistical difference in postoperative results between two groups. There was no perioperative death or occurrence of bronchopleural fistula in both groups. ConclusionCompared with traditional single-port VATS upper lobectomy, preferential bronchoplasty has similar safety and feasibility. In addition, priority bronchoplasty in left upper lobectomy has the advantages of shorter surgical time, less bleeding, more lymph node dissection, and lower conversion rate to multi-port or open surgery.