To investigate the feasibility of complete thoracoscopic lobectomy without using expensive consumables including Endo-cutter, ultrasonic scalpel and Hem-o-lok, so that to decrease hospital cost for patients. Methods Since June 2008 to July 2011 , with instruments for traditional open thoracic surgery, we carried out complete thoracoscopic lobectomy on 36 patients, including 23 cases of malignant lung cancer, 9 cases of benign pulmonary tumor, 3 cases of bronchiectasis, and 1 case of pulmonary cyst. The right lower lobe was removed in 14 cases, the right middle lobe in 4, right upper lobe in 3 , left lower lobe in 10, and left upper lobe in 5. During the procedure, a 1. 5- to 2-em hole was made on the chest wall, and with regular needle and sutures, we ligated the pulmonary vessels and the bronchus, and isolated incomplete laceration of the lung by cutting and suturing with common surgical instruments. Results The mean operation time was 242. 3 min ( 170 -365 min) , and mean intraoperative blood loss was 426.3 ml (220 - 1100 ml). No death nor complications occurred. The mean postoperative hospital stay was 6.6 days (4-14days). Conclusions Complete thoracoscopic lobectomy without using expensive consumables is not only feasible but as effective as the procedure finished by using expensive instruments, and is more economic than the latter.%目的 为降低胸腔镜肺叶切除术的手术费用,探讨在不使用切割闭合器、超声刀、结扎锁等昂贵一次性耗材的条件下,完全胸腔镜(totally thoracoscopic surgery,TTS)肺叶切除术的可行性. 方法 2008年6月～2011年7月,用传统开胸手术器械行36例全胸腔镜下肺叶切除术,包括肺恶性肿瘤23例,肺良性肿瘤9例,支气管扩张3例,肺囊肿1例.右肺下叶14例,右中叶4例,右上叶3例,左下叶10例,左上叶5例.患侧胸壁做3个1.5 ～2.0 cm小孔,胸腔镜下用普通针线缝扎肺血管和支气管,用普通器械采取切开缝扎方式分离不全肺裂. 结果 手术时间170～365 min,平均242.3 min.出血220 ～1100 ml,平均426.3 ml,无死亡,无并发症.术后住院时间4～14 d,平均6.6d. 结论 不使用昂贵耗材,在完全胸腔镜下行肺叶切除术,不仅可行,而且也能达到同样的治疗效果,并且可以节省大量的医疗费用.
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