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[目的]探讨电视胸腔镜辅助小切口(video-assisted mini-thoractomy,VAMT)手术在有胸膜腔粘连的早期非小细胞肺癌患者根治术中的临床应用价值。[方法]回顾性分析2007年1月～2009年1月我科行VAMT肺癌根治术中发现有肺粘连的患者32例,均为Ⅰ、Ⅱ期非小细胞肺癌,其中胸膜呈条索状粘连15例,局限性纤维素膜状粘连9例,全肺弥漫性纤维素粘连8例。[结果]32例均在VAMT术下成功分离粘连,并行肺叶切除术及肺门纵隔淋巴结清扫术。平均手术时间126min,术中平均失血385ml,术后胸管平均引流量770ml,平均引流时间3d,术后平均住院7d,平均清扫淋巴结13枚。[结论]胸膜腔粘连不是早期非小细胞肺癌VAMT根治手术的绝对禁忌证,VAMT手术在有胸膜腔粘连的早期肺小细胞癌患者的根治术中是可行的。
[Objective] To investigate the clinical value of video-assisted mini-thoractomy (VAMT) in the treatment of patients with early stage non-small cell lung cancer with pleural cavity adhesion. [Methods] A retrospective analysis of 32 patients with pulmonary adhesions found during radical mastectomy of VAMT lung cancer from January 2007 to January 2009 in our department was stage I and II non-small cell lung cancer, of which pleural adhesions 15 cases, the limitations of cellulose membranous adhesions in 9 cases, pulmonary diffuse cellulose adhesions in 8 cases. [Result] All the 32 cases were successfully isolated adhesions under VAMT, concurrent lobectomy and hilar mediastinal lymph node dissection. The mean operative time was 126 minutes. The average intraoperative blood loss was 385ml. The average postoperative chest tube drainage volume was 770ml. The mean drainage time was 3 days. The average postoperative hospitalization was 7 days and the average lymphadenectasis was 13. [Conclusions] Pleural adhesion is not the absolute contraindication to radical surgery of VAMT in early non-small cell lung cancer. VAMT surgery is feasible in radical surgery of patients with early stage small cell lung cancer with pleural cavity adhesion.