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find Keyword "肺段" 78 results
  • 单操作孔电视胸腔镜下解剖性肺段及肺楔形切除一例

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  • Complete Video-assisted Thoracoscopic Anatomic Segmentectomy:A Report of 26 Cases

    Objective To evaluate the feasibility and safety of complete video-assisted thoracoscopic surgery (VATS)anatomic segmentectomy. Methods Clinical data of 26 patients with lung diseases who underwent complete VATS anatomic segmentectomy in the First Affiliated Hospital of Nanjing Medical University from November 2010 to July 2011 were retrospectively analyzed. There were 8 male and 18 female patients with their age of 13-81 (53.2±3.1) years. There were 23 patients with pulmonary nodules including 13 patients who underwent direct surgical resection and 10 patients with ground-glass opacity nodules (3 patients received preoperative localization and the other 7 patients received direct surgical resection). All the 3 patients with non-nodule pulmonary diseases (bronchiectasis, pulmonary bulla and pulmonary cyst respectively) underwent direct surgical resection. Results All the 26 patients received complete VATS anatomic segme- ntectomy successfully. The operation time was 150-250 (193.7±7.3) min,and intraoperative blood loss was 10-200 (65.7±12.7) ml. Patients with lung cancer received 4-7 (5.1±0.3) stations of lymph node dissection and the number of lymph node dissection was 4-16 (12.3±0.5) for each patient. There was no in-hospital death or postoperative complication. Postoperative thoracic drainage time was 3-7 (3.9±0.4) days. All the patients were discharge uneventfully. Lung cancer patients were followed up for 3-6 months without recurrence or metastasis. Conclusion Complete VATS anatomic segmentectomy is a safe and feasible surgical procedure.

    Release date:2016-08-30 05:46 Export PDF Favorites Scan
  • 电视胸腔镜手术中缝线定位法在肺部非浅表小结节活检和切除术中的应用

    目的 介绍电视胸腔镜手术中缝线定位法在肺部非浅表结节活检及切除术中的应用。 方法 回顾性分析华西医院胸外科2010年1月至2012年12月间所行的胸腔镜肺小结节楔形切除活检及肺段切除的患者52例的临床资料,其中男26例、女26例,年龄38~81 (54.0±11.6) 岁。术中以腔镜肺叶钳经副操作孔将目标肺叶向主操作孔牵拉,手指通过主操作孔对目标区域进行触诊,探及感知到结节后用2-0带针缝线于结节所投射的肺表面缝合一针作为目标结节切除的牵引线或标记线。 结果 本组52例患者均于胸腔镜下取得病理学诊断,肿瘤直径0.6~2.2(1.6±0.4) cm,且肿瘤与正常肺组织切缘≥2 cm,切缘阴性。原发性肺癌31例(59.6%),其中毛玻璃样病变(GGO)占51.6% (16/31);转移瘤7例(13.5%);良性病变13例(25.0%)。本组平均术后住院时间(6.4±2.7) d,主要术后并发症为:术后持续肺漏气>7 d和术后咯血。全组患者无围手术期死亡。 结论 本方法可使肺部非浅表小结节易于定位,应用条件也无特殊要求,值得推广。

    Release date:2016-08-30 05:47 Export PDF Favorites Scan
  • Progress of Thoracoscopic Pulmonary Segmentectomy for Early-Stage Non-small Cell Lung Cancer

    Abstract: The principles of 2010 National Comprehensive Cancer Network(NCCN) clinical practice guidelines in non-small cell lung cancer address that anatomic pulmonary resection is preferred for the majority of patients with non-small cell lung cancer and video-assisted thoracic surgery (VATS) is a reasonable and acceptable approach for patients with no anatomic or surgical contraindications. By reviewing the literatures on general treatment, pulmonary segmentectomy, pulmonary function reserve, and the anatomic issue of early stage non-small cell lung cancer surgery, the feasibility and reliability of thoracoscopic pulmonary segmentectomy are showed.

    Release date:2016-08-30 05:49 Export PDF Favorites Scan
  • Total Thoracoscopic Anatomic Pulmonary Segmentectomy for 20 Patients

    Abstract: Objective To evaluate the safety and efficacy of total thoracoscopic anatomic pulmonary segmentectomy for the treatment of early-stage peripheral lung carcinoma, pulmonary metastases and benign pulmonary diseases. Methods We retrospectively analyzed 20 patients who received total thoracoscopic anatomic pulmonary segmentectomy in Zhongshan Hospital of Fudan University from March 2008 to November 2011. There were ten male and ten female patients with a mean age of 58.0(14-86)years. Three ports were used. The pulmonary artery and vein of the segment were dealt with Hem-o-lok or stapler. The bronchi of the segment were dealt with staplers. Staplers were used in peripheral lung of intersegmental plane. Results All the twenty patients underwent total thoracoscopic anatomic segmentectomy successfully without any conversion to thoracoctomy or lobectomy. No perioperative morbidity or mortality occurred. Postoperative pathological examinations showed lung cancer in 10 patients, pulmonary metastases in 3 patients and benign pulmonary diseases in 7 patients. The mean operative time was 133.0(90-240)min. The mean blood loss was 85.0(50-200)ml. The chest tubes were maintained in position for 3.2 (2-7) d. The mean postoperative hospitalization time was 6.7 (4-11)d. Conclusion Total thoracoscopic anatomic pulmonary segmentectomy is a feasible and safe technique to be used selectively for Ⅰa stage lung cancer, pulmonary metastases and benign pulmonary diseases that are not appropriate for wedge resection.

    Release date:2016-08-30 05:50 Export PDF Favorites Scan
  • 肺段支气管剔除治疗支气管扩张症的疗效

    目的 观察肺段支气管剔除治疗支气管扩张症的疗效与安全性。 方法 回顾性分析武警甘肃总队医院2004年12月至2007年12月均经支气管碘油造影、胸部X线片及胸部CT检查确诊的支气管扩张症30例患者的临床资料,其中男21例,女9例;年龄31.9 (16~41)岁。其中囊性扩张6例,柱状扩张9例,混合性扩张15例;双侧病变8例,单侧病变22例。全组患者均行肺段支气管剔除术,观察其疗效。 结果 共剔除肺段支气管64支,手术时间为50~180 min。术中失血量380 (300~600) ml,手术当天胸腔引流量350~550 ml,无手术死亡。术后第3~5 d拔除胸腔引流管。术后胸部X线片示肺膨胀良好,无残腔。术后1例出现肺不张,经纤维支气管镜吸痰后肺复张。住院时间2~3周。随访6个月,患者症状消失,复查血气分析检查均正常,胸部X线片示肺膨胀良好,未发现残腔、积液。无1例复发,病理诊断均为支气管扩张症。 结论 掌握好手术条件,采用肺段支气管剔除术代替肺段切除术治疗支气管扩张症可行,手术方法简单,出血少,减少了术后并发症,克服了以往手术术式的不足,值得临床推广。

    Release date:2016-08-30 05:51 Export PDF Favorites Scan
  • Application of A Silicone Guiding Tube for Endoscopic Linear Stapling Device in Complete Video-Assisted ThoracoscopicLobectomy and Segmentectomy

    Abstract: Objective To investigate the application of a silicone guiding tube for endoscopic linear stapling device in complete video-assisted thoracoscopic lobectomy and segmentectomy,so as to improve the safety and efficiency of manipulating the endoscopic linear stapling device. Methods We retrospectively analyzed clinical data of 178 patients with peripheral non-small cell lung caner and 26 patients with benign lung lesions who underwent surgical resection in First Affiliated Hospital of Nanjing Medical University from October 2009 to December 2011. There were 85 males and 119 females with their average age of 62±11 years. A total of 172 patients underwent complete video-assisted thoracoscopic lobectomy and 32 patients underwent segmentectomy. We designed a silicone guiding tube to facilitate the use of endoscopic linear stapling device. With the help of the tube, a1l pulmonary arteries, veins, bronchus and interlobar fissure involved were managed with endoscopic linear stapling devices. Results Three patients (1.47%)underwent conversion to thoracotomy because of dense lymph node adhesion, and all other complete video-assisted thoracoscopic surgeries were successfully performed. There was no blood vessel injury, severe postoperative complications or perioperative death. The use rate of the tube was 95.6% (303/317), 66.9% (115/172), 22.7% (39/172) and 78.5% (255/325) in pulmonary arteries, veins, bronchus and interlobar fissure stapling for lobectomy respectively, and 94.4% (34/36), 77.3% (17/22), 25.0% (8/32), 33.1% (45/136) in pulmonary arteries, veins, bronchus and interlobar fissure stapling for segmentectomy respectively. For lobectomy, a total of 986 staples were used with an average of 5.7 staples for each patient, the average operative time was 192.5±54.0 min and average intraoperative blood loss was 118.1±104.1 ml. For segmentectomy, a total of  226 staples were used with an average of  7.1 staples for each patient, the average operative time was 193.7±37.4 min and average intraoperative blood loss was 60.9±78.0 ml. Conclusion Using a silicone guiding tube can facilitate the application of endoscopic linear stapling device, shorten the learning curve of complete video-assisted thoracoscopic lobectomy and segmentectomy, and improve the safety, convenience and economical efficiency of endoscopic linear stapling device.

    Release date:2016-08-30 05:51 Export PDF Favorites Scan
  • Da Vinci Robotic Lung Segmentectomy and Thoracoscopic Lung Segmentectomy: A Case Control Study

    ObjectiveTo evaluate the curative and economic effect of da Vinci robotic lung segmentectomy. MethodWe retrospectively analyzed clinical data of 13 patients who underwent robotic lung segmentectomy (as a robotic group) and 35 patients who underwent thoracoscopic lung segmentectomy (as a thoracoscopic group) in our hospital between September 2014 and April 2015. There were 4 males and 9 females at age of 43-73 (59.1±8.9) years in the robot group and 17 males and 18 females in the thoracoscopic group at age of 30-79 (59.1+12.0) years. Effects of the two groups were compared. ResultsPostoperative hospitalization time in the robotic group was shorter than that in the thoracoscopic group (4.4±0.8 d vs. 6.3±2.5 d, P<0.05). But the cost of hospitalization in the robotic group was higher than that in the thoracoscopic group (P<0.05). The surgery indwelling catheter time and incidence of complications in the robotic group were lower than those in the thoracoscopic group with no statistical difference (P=0.053, 0.081). ConclusionRobotic lung segmentectomy is a safe and feasible operation method. With the further accumulation of clinical experience and decrease of the cost of materials, the robot will play a more important role in the future of minimally invasive thoracic surgery.

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  • Segmentectomy versus Lobectomy for Non-small Cell Lung Cancer: A Case Control Study

    ObjectiveTo evaluate the safety and efficacy of segmentectomy for early stage non-small cell lung cancer. MethodsWe retrospectively analyzed the clinical data of 88 patients with pulmonary malignant or benign lung tumor who underwent segmentectomy in our hospital between January 2007 and December 2012. There were 45 male and 43 female patients. There were 29 patients in the segmentectomy group and 59 patients in the lobectomy group. Nonsmall cell lung cancer patients underwent segmentectomy were matched with non-small cell lung cancer patients who underwent lobectomy. Perioperative factors and tumor relative prognosis were analyzed. ResultsSegmentectomy were performed in 29 patients in our institution. Average operation time was 210 minutes. Intraoperative blood loss was 166 ml. Postoperative drainage was 2 147 ml. The average extubation duration was 6 days. No significant difference was found in operation time (P>0.999), intraoperative blood loss (P=0.207), postoperative drainage (P=0.946), extubation duration (P=0.804), and postoperative complication (P>0.999) between segmentectomy pulmonary benign disease and segmentectomy lung cancer groups. Compared with lobectomy, segmentectomy showed similar operation time (P=0.462), intraoperative blood loss (P=0.783), extubation duration (P=0.072), complication ratio (P>0.999), and postoperative recurrence/metastasis ratio (P=0.417). While the number of N1 lymph nodes (P=0.033) and N1 station (P=0.024) were fewer in the segmentectomy group than those in the lobectomy group. The overall survival rate (P=0.340) and disease free survival rate (P=0.373) were both comparable between the segmentectomy and the lobectomy group. ConclusionSegmentectomy could be an alternate of lobectomy for patients with selective pulmonary benign disease, and for some early stage non-small cell lung cancer patients with restricted pulmonary function.

    Release date:2016-10-02 04:56 Export PDF Favorites Scan
  • Application of 3D Digital Lung Software in Preoperative Planning of Patients with Mul-tiple Pulmonary Nodules and Poor Pulmonary Function

    ObjectiveTo assess the feasibility of 3D digital lung software used in preoperative planning of patients with multiple pulmonary nodules and poor pulmonary function. MethodsFive patients with multiple pulmonary nodules in the left lung, meanwhile with a history of single lung lobectomy in the right lung were included in our hospital between June and December 2015. There were 4 males and 1 female at an average age of 50.4±2.6 years. A 320-slice volumetric CT scanner was used to the CT angiography (CTA) of the pulmonary artery. The data of CT images were imported into the 3D digital lung software that was researched and developed by Xiamen QiangBen Science and Technology Company. The 3D reconstruction of digital virtual lung was completed by this software based on those data. At the same time the soft-ware completed the automatic segmentation of the lung based on the pulmonary artery system and the 3D reconstruction of the pulmonary nodules. The 3D digital lung software calculated the volume proportion of the intended removal (segm-ental lesions) to the whole lung, estimated the effect of surgery on forced expired volume in one second (FEV1), and the patient's tolerance ability to surgery. After the preoperative planning, the patients received multiple pulmonary segmental/subsegmental resection under the general anesthesia by video-assisted thoracoscopic surgery (VATS). ResultsThe 3d reconstruction of the pulmonary arteries reached 5 levels in 5 patients. And the software automatically identified out the lung segment/subsegment to show the lung nodules of lung segment/subsegment. The preselection lung volume of 5 patients accounted for 14.00%-27.00% of total lung volume. The software estimated FEV1 as 1.16-1.46 L which can tolerate the operation. The 5 patients were successfully performed surgery of multiple pulmonary segmental/subsegmental resection under the general anesthesia by VATS. The software located lung nodules from the resection of pulmonary segments during operation immediately. Then we sent them to the rapid pathological examination for diagnosis. After operation, the patients recovered well, and had no respiratory insufficiency. Hospitalization day was 4 days. ConclusionThe 3D digital pulmonary software can not only automatically identify the pulmonary segments, precisely position the pulmonary nodule, show the relationship among the target pulmonary segments artery, vein, bronchus and the surroun-ding artery, vein, and bronchus, but also calculate the volume of the pulmonary segments, estimate the impact of the pulmonary segmentectomy on the FEV1. It is useful for precise evaluation of the tolerant capacity of multiple pulmonary nodules in patients with unstaged multiple pulmonary segments.

    Release date:2016-11-04 06:36 Export PDF Favorites Scan
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