單孔胸腔鏡技術(shù)治療進(jìn)展河南大學(xué)第一附屬醫(yī)院胸心血管外科楊忠信zhongxin1985@163.comWechat胸單孔胸腔鏡治療進(jìn)展經(jīng)劍突下單孔胸腔鏡治療進(jìn)展病例分享UniportalHistory:單孔內(nèi)鏡下手汗癥治療自1995年1月100例患者（46例女性、54例男性）接收雙側(cè)單孔內(nèi)鏡下手汗癥治療。雙側(cè)同期在30分鐘內(nèi)完成96%患者順利康復(fù)并第2天出院

手術(shù)時(shí)間、住院時(shí)間縮短、療效均優(yōu)于開(kāi)放手術(shù)Vanaclocha.Uniportalendoscopicsuperiorthoracicsympathectomy.Neurosurgery.2000Apr;46(4):924-8.

UniportalHistory:經(jīng)肋間單孔胸腔鏡下肺楔形切除GaetanoRocco.UniportalVATSwedgepulmonaryresections.TheAnnalsofThoracicSurgery.

2004Feb;77(2):726-8.

自2000年15例患者，其中10例不明原因肺間質(zhì)病變，5例自發(fā)性氣胸患者行單孔胸腔鏡下肺楔形切除肺間質(zhì)病變患者均明確診斷，氣胸患者無(wú)復(fù)發(fā)單孔胸腔鏡手術(shù)行肺楔形切除是安全有效的UniportalHistory:經(jīng)肋間單孔胸腔鏡下肺楔形切除單孔VS標(biāo)準(zhǔn)三孔胸腔鏡手術(shù)治療自發(fā)性氣胸：術(shù)后疼痛和感覺(jué)異常比較RajwinderSinghJutleyetal.Uniportalvsstandardthree-portVATStechniqueforspontaneouspneumothorax:comparisonofpost-operativepainandresidualparaesthesia.EurJCardiothoracSurg2005;28:43-46UniportalHistory:單孔胸腔鏡下心包開(kāi)窗術(shù)GaetanoRocco.Uniportalvideo-assistedthoracoscopicsurgerypericardialwindow.TheJournalofThoracicandCardiovascularSurgery

2006131,921-922DOI:GaetanoRocco等報(bào)導(dǎo)了自02年至05年4例患者，2例男性淋巴瘤患者和2例女性乳腺癌患者心包侵襲，行單孔胸腔鏡下心包開(kāi)窗術(shù)。UniportalHistory:單孔胸腔鏡用于縱膈淋巴結(jié)診斷及分期GaetanoRoccoetal.UniportalVATSformediastinalnodaldiagnosisandstaging.InteractCardioVascThoracSurg2006;5:430-432自2002年1月至2005年10月，13例患者（8例男性，5例女性）行單孔胸腔鏡下縱膈淋巴結(jié)采樣13例均明確病理診斷住院時(shí)間1天，無(wú)死亡或者并發(fā)癥發(fā)生安全有效的用于縱膈淋巴結(jié)分期DiegoGonzalez.thoracoscopicanatomicsegmentectomyandrightupperlobectomy.EurJCardiothoracSurg2012;42:e169-e171UniportalHistory:單孔胸腔鏡下解剖型肺段切除+右上肺葉切除

45歲女性吸煙患者CT提示右上肺一2cm結(jié)節(jié)和下葉背段一大小約1cm行單孔胸腔鏡下右上葉切除和背段切除，因?yàn)橄氯~結(jié)節(jié)較深，無(wú)法行楔形切除，所以行背段切除，手術(shù)時(shí)間150min術(shù)后病理提示上葉腺癌，淋巴結(jié)N0，下葉結(jié)節(jié)提示錯(cuò)構(gòu)瘤(A)Thesurgicalimageofinstrumentationduringsegmentectomy.

Diegothoracoscopicanatomicsegmentectomyandrightupperlobectomy.EurJCardiothoracSurg2012;42:e169-e171DiegoGonzalez-Rivasetal.Uniportalvideo-assistedthoracoscopicbronchialsleevelobectomy:firstreport.TheJournalofThoracicandCardiovascularSurgery

2013145,1676-1677DOI:(10.1016/j.jtcvs.2013.02.052)UniportalHistory:單孔胸腔鏡下支氣管袖式切除術(shù)：首例報(bào)導(dǎo)

55歲男性，行誘導(dǎo)化療后CT提示腫瘤位于右上肺支氣管管口阻塞并肺不張，患者取左側(cè)臥位，經(jīng)右側(cè)第5肋間一長(zhǎng)約5cm手術(shù)切口，手術(shù)時(shí)間240分鐘術(shù)后病理提示一大小約1.7cm氣管鱗癌，淋巴結(jié)癌轉(zhuǎn)移（0/25）DiegoGonzalez-Rivasetal.leftlowersleevelobectomybyuniportalVATSapproach.

InteractCardioVascThoracSurg2014;18:237-239UniportalHistory:單孔胸腔鏡下左下肺袖式切除71歲女性CT提示腫瘤位于左下肺支氣管累計(jì)主支氣管患者取右側(cè)臥位，左側(cè)第5肋間長(zhǎng)約5cm切口，手術(shù)時(shí)間250min術(shù)后病理提示2.5cm腫瘤，無(wú)淋巴結(jié)轉(zhuǎn)移（T1bN0M0）。Sequenceofsleeveresectionandanastomosis.DiegoGonzalez-Rivasetal.leftlowersleevelobectomybyuniportalVATSapproach.

InteractCardioVascThoracSurg2014;18:237-239UniportalHistory:單孔胸腔鏡下雙袖式切除65歲男性，有吸煙史初次發(fā)現(xiàn)CT提示左上肺7.2cm腺癌包繞血管及支氣管6次化療后效果差，CT提示腫瘤進(jìn)展至9cm行單孔胸腔鏡下左上肺雙袖式切除DiegoGonzalez-RivasetalDoublesleeveuniportalvideo-assistedthoracoscopiclobectomyfornon-smallcelllungcancer.

/pubmed/100865732014Mar;3(2):E2.doi:10.3978/j.issn.2225-319X.2014.03.13.雙袖式切除.mp4UniportalHistory:非氣管插管單孔胸腔鏡下肺葉切除術(shù)Firstcase：50歲女性，右上肺4cm腺癌，無(wú)淋巴結(jié)轉(zhuǎn)移，行非氣管插管單孔胸腔鏡下右上肺葉切除Secondcase：60歲男性，右上肺3cm腫瘤，行右上肺葉切除+系統(tǒng)性淋巴結(jié)清掃Thirdcase：60歲男性，左上肺4.2cm非小細(xì)胞肺癌侵及胸壁，行左上肺切除+淋巴結(jié)清掃DiegoGonzalez-Rivasetal.Non-intubated(tubeless)uniportalvideo-assistedthoracoscopiclobectomy.

/pubmed/252405262016Mar;5(2):151-3.doi:10.21037/acs.2016.03.02.非氣管插管肺葉切除.mp4SubxiphoidUniportalVATS:胸骨下入路前縱隔腫瘤切除KidoTetsuo1.Resectionofanteriormediastinalmassesthroughaninfrasternalapproach.T.AnnThoracSurg.1999Jan;67(1):263-5.三例女性前縱隔良性腫瘤患者行經(jīng)胸骨下入路前縱膈腫瘤切除，使用胸骨抬高系統(tǒng)術(shù)后病理1例胸骨后甲狀腺腫，胸腺及脂肪切除，1例囊性畸胎瘤SubxiphoidUniportalVATS:劍突下單孔左上肺葉切除LiuCC.Subxiphoid

single-incisionthoracoscopicleftupper

lobectomyJThoracCardiovascSurg.

2014Dec;148(6):3250-1.doi:10.1016/j.jtcvs.20