Objective To analyze the postoperative curative effect of video-assisted thoracoscopy in the treatment of patients with pulmonary nodules which diameter was less than 2. 0 cm. Methods 62 patients with pulmonary nodules which diameter was less than 2. 0 cm were treated with thoracoscopy assisted small incision thoracotomy surgery. Their sections were frozen to find out the pathological mechanism. Those patients were followed up 3 years. Results 36 cases were malignant tumors, which was accounting for 58. 1% and given VATS assisted small incision pulmonary lobectomy and mediastinal lymph node dissection. 13 cases were inflammatory pseudotumors, which took up 20. 9% and were treated with wedge resection of lung. 10 oases were tuberculoma, which were also treated with wedge resection of lung. 2 cases were bullae of lung and treated with ligation. 1 case was pulmonary cyst and given pulmonary lobectomy. There was no perioperative death and serious complications reported. The benign patients had a long-term survival without recurrence and sequelae postoperatively. The 5-year survival rate of the malignancy group was 56. 3% . Conclusion Video assisted thoracic operation has the advantages of light trauma, pain and impairment of lung function, rapid postoperative recovery, and few adverse reactions.%目的 分析肺部直径小于2.0 cm结节病灶的术后疗效.方法 对我院收治的62例直径小于2.0 cm肺部结节的患者采用胸腔镜辅助小切口开胸方法进行手术治疗,术中送冰冻切片病理检查,根据病理结果选择不同手术方式,对结节所在肺组织进行切除,并对患者进行3年随访.结果 62例患者中恶性肿瘤36例,占58.1%,行VATS辅助小切口下行肺叶切除及纵隔淋巴结清扫;炎性假瘤13例,占20.9%,行肺楔形切除术;结核球10例,占27.8%,行肺楔形切除术;肺大疱2例,占3.2%,行肺大疱结扎术;肺囊肿1例,占1.6%行病灶处肺叶切除.患者无围手术期死亡,未出现严重的手术并发症,术后随访良性病变者术后长期生存,无复发,无后遗症.结论 电视胸腔镜手术具有创伤小,疼痛轻,对肺功能损害小,术后恢复快、不良反应少等优点.
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