XU Chang,LUO qi-cheng,YANG xiao-dong,et al.Eight cases of video-assisted thoracoscopic surgery in children for lobectomy[J].Journal of Clinical Pediatric Surgery,2013,12(02):117-119.[doi:10.3969/j.issn.1671— 6353.2013.02.012]
儿童胸腔镜下肺叶切除术8例
- Title:
- Eight cases of video-assisted thoracoscopic surgery in children for lobectomy
- Keywords:
- Thoracoscopy; Lung Diseases; Thoracic Surgical Procedures; Child
- 摘要:
- 目的 总结本院8例胸腔镜下肺叶切除术患儿的手术经验,探讨儿童胸腔镜下肺叶切除术的可行性。 方法 回顾性分析2011年7月至2012年12月我们实施的8例儿童胸腔镜肺叶切除术患儿临床资料,对其诊治经过及手术经验进行初步总结。 结果 8例患儿中,男5例,女3例,年龄4～11岁。切除左肺下叶4例,左肺上叶2例,右肺下叶2例。除1例11岁患儿术中行单肺通气外,其余10岁以下患儿均行双肺通气。2例术中中转开放手术,其余在胸腔镜下顺利完成手术。术中出血10～30 mL,手术时间50～90 min。术后病理报告:肺腺瘤样囊性病变7例,叶内型隔离肺1例。术后第3～4天拔除胸腔闭式引流管,术后6～7 d出院,无严重手术并发症出现。近期随访患侧剩余肺叶均代偿良好。 结论 胸腔镜肺叶切除术术野显露清楚,创伤小,手术时间短,患儿痛苦小,术后恢复快,呼吸系统并发症少。大龄儿童单肺通气能增加操作空间,同时肺萎陷后也有利于肺门部的解剖,使手术简化。若能掌握指征和操作技巧,即使没有单肺通气情况下,同样具有一定的可行性。
- Abstract:
- Objetive Summarize the operation experience of vats lobectomy for 8 cases, this paper discusses the feasibility of vats lobectomy resection for children. Methods analyse the implementation of 8 cases of children under video-assisted thoracoscopic surgery(vats lobectomy combined with case material from July 2011 to December 2012, And make a tentative summary experience for the treatment after operation. Results 5 cases were male, female 3 cases in the eight cases,,aged 4 to 11 years.The left lung resection of lower lobe 4 cases, the left upper lobe lung in 2 cases, 2 cases of the lower lobe. Except 1 case was 11 years old children among single pulmonary ventilation outside, the rest of the children under the age of 10 are line double pulmonary ventilation.2 cases intraoperative transit open surgery, and the rest in the under complete thoracoscopy operation. Intraoperative bleeding 10～30 mL, surgery time is fifty to 90 minute.Pulling thoracic closed drainage tube after 3～4 days,discharge postoperative 6～7 days, no serious complications appear.Recent follow-up with side residual lung lobe are compensated well. Conclusions Thoracoscope lung lobe resection operation field show clear, little trauma, surgical time is short, the pain is little of children and postoperative recovery very fast, respiratory system less complications.Senior one lung ventilation can increase operating space, and at the same time, atelectatic lungs also avail to the department of anatomy, to make surgery simplified.If master the indications and operation skills, even if no one lung ventilation situation, also has certain feasibility.
参考文献/References:
1 Jacobeus HC. The practical importance of thoracoscopy in surgery of the chest[J]. Surg Gynecol Obstet,1921,4:28 9— 296. 2Rodgers BM, Moazam F, Talbert JL. Thoracoscopy in children[J]. Ann Surg, 1979,189:17 6— 180. 3蒲强,刘伦旭,车国卫,等. 单向式全胸腔镜肺叶切除手术治疗肺良性疾病的临床研究[J].四川大学学报(医学版),2010,41:54 8— 550. 3Rothenberg SS. First decade’s experience with thoracoscopic lobectomy in infants and children[J]. J Pediatr Surg,2008,43:40 — 44. 4Albanese CT, Rothenberg SS. Experience with 14 4consecutive pediatric thoracoscopic lobectomies[J]. J Laparoendosc Adv Surg Tech A, 2007,17:33 9— 341. 5Rothenberg SS. Thoracoscopic pulmonary surgery[J]. Semin Pediatr Surg,2007,16:231 — 237. -----------------------------------------------
相似文献/References:
[1]阳广贤高纪平刘平波曾德斌.NUSS手术矫治先天性漏斗胸102例[J].临床小儿外科杂志,2010,9(03):0.
YANG Guang-xian,GAO Ji-ping,LIU Ping-bo,et al.NUSS procedure for pectus excavatum repair in 102 patients.[J].Journal of Clinical Pediatric Surgery,2010,9(02):0.
[2]刘向阳 李洪涛 齐子龙. 胸腔镜治疗小儿急性脓胸8例[J].临床小儿外科杂志,2012,11(05):389.
[J].Journal of Clinical Pediatric Surgery,2012,11(02):389.
[3]阳广贤 刘剑 邓喜成. 儿童先天性肺囊性疾病69例诊疗分析[J].临床小儿外科杂志,2014,13(04):294.
[4]陶俊峰 黄金狮 陶强. 胸腔镜技术治疗先天性食管闭锁术后食管狭窄的相关因素分析[J].临床小儿外科杂志,2014,13(05):377.
[5]段贤伦,商子寅,章鹏,等. 胸腔镜在小儿纵膈肿物治疗中的应用[J].临床小儿外科杂志,2016,15(02):135.
[6]徐新利,王皓洁,张治超,等.两种手术治疗先天性食管闭锁并食管气管瘘的对比研究[J].临床小儿外科杂志,2018,17(03):184.
Xu Xinli,Wang Haojie,Zhang Zhichao,et al.Comparative study of thoracoscopy and thoracotomy in the treatment of congenital esophageal atresia complicated with esophagotracheal fistula.[J].Journal of Clinical Pediatric Surgery,2018,17(02):184.
[7]张娜,曾骐,陈诚豪,等.胸腔镜手术与开胸手术对不同类型小儿肺隔离症的适应性研究[J].临床小儿外科杂志,2018,17(05):336.
Zhang Na,Zeng Qi,Chen Chenghao,et al.Comparative study of outcomes for thoracoscopic versus open resection of pulmonary sequestration at a single pediatric institution:a report of 208 cases.[J].Journal of Clinical Pediatric Surgery,2018,17(02):336.
[8]王允金,周朝明,崔旭,等.不同手术方式治疗小儿肺隔离症的比较研究[J].临床小儿外科杂志,2018,17(05):345.
Wang Yunjin,Zhou Chaoming,Cui Xu,et al.Clinical efficacies of different surgical approaches for pediatric pulmonary sequestration.[J].Journal of Clinical Pediatric Surgery,2018,17(02):345.
[9]程千千,吴晔明,王俊,等.影响新生儿膈疝生存率的相关因素分析——开放手术与腔镜下手术比较[J].临床小儿外科杂志,2019,18(03):237.[doi:10.3969/j.issn.1671-6353.2019.03.016]
Cheng Qianqian,Wu Yeming,Wang Jun,et al.Analysis of related factors affecting neonatal sputum survival rate-Comparison between open surgery and endoscopic surgery[J].Journal of Clinical Pediatric Surgery,2019,18(02):237.[doi:10.3969/j.issn.1671-6353.2019.03.016]
[10]岳芳,王贤书,杨志国,等.胸腔镜与开胸手术治疗婴幼儿先天性膈膨升的对比研究[J].临床小儿外科杂志,2019,18(06):508.[doi:10.3969/j.issn.1671-6353.2019.06.014]
Yue Fang,Wang Xianshu,Yang Zhiguo,et al.Comparison of thoracotomy versus thoracoscopy in the treatment of diaphragmatic eventration in children[J].Journal of Clinical Pediatric Surgery,2019,18(02):508.[doi:10.3969/j.issn.1671-6353.2019.06.014]
[11]张玉喜,庄著伦,莫绪明,等. 电视胸腔镜与传统开胸手术在小儿肺叶切除中的比较[J].临床小儿外科杂志,2016,15(02):121.