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学科主题: 临床医学
题名:
Indications for conversion of thoracoscopic to open thoracotomy in video-assisted thoracoscopic lobectomy
作者: Li, Yun; Wang, Jun; Yang, Fan; Liu, Jun; Li, Jianfeng; Jiang, Guanchao; Zhao, Hui
关键词: completely thoracoscopic lobectomy ; conversion ; indication ; malignancy ; thoracotomy
刊名: ANZ JOURNAL OF SURGERY
发表日期: 2012-04-01
DOI: 10.1111/j.1445-2197.2011.05997.x
卷: 82, 期:4, 页:245-250
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Surgery
研究领域[WOS]: Surgery
关键词[WOS]: THORACIC-SURGERY LOBECTOMY ; LONG-TERM OUTCOMES ; I LUNG-CANCER
英文摘要:

Backgroud: The study aims to discuss indications for conversion to thoracotomy in completely thoracoscopic lobectomy. Methods: From September 2006 to April 2010, 306 patients (164 men, 142 women, median age 58.1 years, range 15 to 86 years) underwent completely thoracoscopic lobectomy. There were 223 cases of primary lung cancer, 11 other malignant diseases and 72 cases of benign disease. The steps of the thoracoscopic procedures are almost identical to those of traditional open lobectomy, which requires standard mediastinal lymph node dissection for primary lung cancer patients. When conversion to an open procedure is necessary, such as in the presence of lymph node adhesions or metastases and bleeding, operative incisions are extended 12-15 cm towards lower angle of the scapula, retractors are used to separate the ribs, and the procedure is completely under direct visualization. Results: All procedures were performed without significant complications or intraoperative deaths. The average surgical duration was 195 min, and average blood loss was 256 mL with no blood transfusions required. The average chest tube drainage duration was 7.45 days. The average post-operative hospital stay was 10.34 days. There were 27 cases (8.8%) of conversion to open thoracotomy, for the reasons of interference by lymph nodes (n = 18), bleeding (n = 4), inflammatory adhesions of arteries (n = 3) and large size tumours (n = 2). Conclusion: Adhesions or lymph node metastases and bleeding were the most important causes of conversion to thoracotomy in completely thoracoscopic lobectomy. Large tumours, fused fissures and dense pleural adhesions can always be managed thoracoscopically.

语种: 英语
WOS记录号: WOS:000301782700013
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/65951
Appears in Collections:北京大学第二临床医学院_胸外科_期刊论文

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作者单位: Peking Univ, Peoples Hosp, Dept Thorac Surg, Beijing 100044, Peoples R China

Recommended Citation:
Li, Yun,Wang, Jun,Yang, Fan,et al. Indications for conversion of thoracoscopic to open thoracotomy in video-assisted thoracoscopic lobectomy[J]. ANZ JOURNAL OF SURGERY,2012,82(4):245-250.
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