Background and objective: Video-assisted mini-thoracoscopy (VAMT) has been used for pulmonary lobectomy for 20 years, which has many merits including small wound, less pain and quick recovery. VAMT is the tendency of pectoral minimally invasive surgical treatment. The aim of this study is to evaluate the efficacy of video-assisted mini-thoracoscopy (VAMT) for radical resection of pleomorphic carcinoma of the lung.
Methods: Complete resection of pleomorphic carcinoma of the lung was performed on 28 patients by VMAT. A 1.5 cm and a 6 cm to 8 cm incision was made during the operation. Both standard surgical instruments and thoracoscopic set were used to treat the pulmonary vessels, perform lobotomy, and remove the lymph nodes in the mediastinum and pulmonary portal.
Results: The operation was completed in all of the cases. No peri-operative death occurred. The total volume of hemorrhage was 200 mL to 450 mL (mean, 300 mL). The patients received chest drainage for 3 to 8 days after the operation (mean, 5 d). The time in hospital was 7 d-14 d (mean, 12 d). Five-year overall survival and disease-free survival were 39.2% and 47.1%, respectively. Follow-up was available in all 28 patients for up to 2 to 91 months. Among the 28 cases, only 2 patients died 2 months after the operation, the rest all live up over 1 year. 3-year survival rate was 60.7% (95%CI: 40.3%-81.1%).
Conclusion: VAMT is effective for radical resection of pleomorphic carcinoma of the lung in a short term. Combination the superiority of traditional procedure and VATS, so VAMT is safe and reliable for radical resection of pleomorphic carcinoma of the lung.
背景与目的: 胸腔镜辅助小切口（video-assisted mini-thoracoscopy, VAMT）下完成肺叶切除已有二十年的历史，具有创伤小、术后疼痛轻、肺功能损失少、恢复快等优点，是目前微创胸部外科的发展趋势。本研究旨在探讨胸腔镜辅助小切口肺叶切除术在多形性肺癌治疗中的应用价值。
方法: 应用VAMT行根治性肺叶切除术治疗28例多形性肺癌。采用常规器械与胸腔镜器械相结合直视操作处理肺血管、支气管行肺叶切除，胸腔镜、直视下行纵隔、肺门区淋巴结清扫。
结果: 28例均获成功。无围手术期死亡，术中出血量200 mL-450 mL，平均300 mL；胸管留置时间3 d-8 d，平均5 d，术后总引流量300 mL-800 mL，平均460 mL；术后住院7 d-14 d，平均12 d。随访28例，其中2例患者于术后2个月死亡，其余患者生存均超过1年，3年生存率为60.7%（95%CI: 40.3%-81.1%）。
结论: VAMT治疗多形性肺癌近期疗效良好，既发挥了微创外科的优越性，又达到了传统开胸手术安全、可靠的效果，清扫淋巴结符合肿瘤手术原则，有很好的应用前景。