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find Keyword "双侧手术" 3 results
  • 单孔胸腔镜治疗单侧气胸合并对侧肺大泡疗效分析Effect of uniportal thoracoscopic surgery for unilateral pneumothorax with contralateral pulmonary bullae

    目的 探讨单孔胸腔镜治疗单侧气胸合并对侧肺大泡的安全性、有效性及实用性。 方法 回顾性分析内江市第一人民医院 2012 年 1 月至 2015 年 7 月单孔胸腔镜手术治疗 46 例单侧气胸合并对侧肺大泡患者的临床资料,其中男 29 例、女 17 例,年龄 15~34 岁。术前均经高分辨薄层 CT 检查证实为单侧气胸合并对侧肺大泡,同期行双侧手术。 结果 全组患者均顺利完成手术,无严重并发症及死亡病例。术后随访 1~36 个月,共有 3 例患者复发,其中气胸侧 2 例(4.35%),肺大泡侧 1 例(2.17%)。 结论 单孔胸腔镜治疗单侧气胸合并对侧肺大泡创伤小、安全、有效,能显著降低对侧气胸发生率。

    Release date:2017-01-22 10:15 Export PDF Favorites Scan
  • 同期双侧单孔胸腔镜切除肺多发磨玻璃影的单中心经验

    目的总结双肺多发磨玻璃影(ground-glass opacity,GGO)患者同期行双侧单孔胸腔镜手术切除的经验。方法回顾性分析 2015 年 5 月至 2019 年 10 月同期行双侧单孔胸腔镜肺 GGO 切除 34 例患者的临床资料,其中男 6 例、女 28 例,平均年龄 41~69(57.9±6.7)岁。结果术中平均出血量(120.9±67.7)mL,平均手术时间(140.0±74.8)min,术后平均胸腔引流时间(4.8±3.1)d,术后平均住院时间(7.2±4.3)d。术后并发症包括肺部感染 2 例,心房颤动 3 例,肺持续漏气>3 d 5 例,经治疗后均好转,无围手术期严重并发症及死亡病例。共切除 GGO 病灶 76 个,总恶性率为 81.6%,其中纯 GGO 40 个,恶性 28 个(70.0%),平均直径(9.6±3.8)mm;混合 GGO 36 个,恶性 34 个(94.4%),平均直径(15.6±6.6)mm。平均随访时间 38.4 个月,未发现术后转移及复发。结论双肺多发 GGO 患者的病灶为恶性可能性大,在肺功能允许时可考虑同期双侧单孔胸腔镜多病灶切除,根据病灶位置、大小及术中快速病理结果可灵活采取亚肺叶或肺叶切除方法。双侧同期手术安全可行,不会增加术后并发症风险,短期预后良好。

    Release date:2020-07-30 02:32 Export PDF Favorites Scan
  • Safety and clinical outcomes of thoracoscopic segmentectomy in bilateral lung cancer: A single-center retrospective study

    Objective To assess the safety and clinical outcomes of segmentectomy in one- or two-staged video-assisted thoracoscopic surgery (VATS) for bilateral lung cancer. MethodsWe retrospectively enrolled 100 patients who underwent VATS segmentectomy for bilateral lung cancer at the Department of Thoracic Surgery of Peking Union Medical College Hospital from December 2013 to May 2022. We divided the patients into two groups: a one-stage group (52 patients), including 17 males and 35 females with a mean age of 55.17±11.09 years, and a two-stage group (48 patients), including 16 males and 32 females with a mean age of 59.88±11.48 years. We analyzed multiple intraoperative variables and postoperative outcomes. Results All 100 patients successfully completed bilateral VATS, and at least unilateral lung received anatomical segmentectomy. Patients in the one-stage group were younger (P=0.040), had lower rate of comorbidities (P=0.030), were less likely to have a family history of lung cancer (P=0.018), and had a shorter interval between diagnosis and surgery (P=0.000) compared with patients in the two-stage group. Wedge resection on the opposite side was more common in the one-stage group (P=0.000), while lobectomy was more common in the two-stage group. The time to emerge from anesthesia in the one-stage group was longer than that in the first and second operations of the two-stage group (P=0.000, P=0.002). Duration of surgery and anesthesia were similar between two groups (P>0.05). Total number of lymph node stations for sampling and dissection (P=0.041) and lymph nodes involved (P=0.026) were less in the one-stage group. Intraoperative airway management was similar between two groups (P>0.05). The one-stage group was associated with lower activities of daily living (ADL) scores. Conclusion Segmentectomy is safe in one- or two-staged VATS for bilateral lung cancer, including contralateral sublobectomy and lobectomy. Duration of surgery and perioperative complications are similar between two groups, but the one-stage group is associated with lower ADL scores. On the basis of comprehensive consideration in psychological factors, physical conditions and personal wishes of patients, one-staged sequential bilateral VATS can be the first choice.

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