完全胸腔鏡下肺全摘除術

Experience of Complete Video-assisted Thoracoscopic Pneumonectomy

国内の多くの施設で肺癌に対して胸腔鏡下手術（VATS）が導入されている．VATSにはutility incisionを用いたものと，これを用いない完全VATS（cVATS）があり，当科では2020年6月から主としてcVATSでの肺全摘除術を行っており，これまで経験した3例について考察する．

Thoracotomy has been preferred to video-assisted thoracoscopic surgery （VATS） for performing pulmonary pneumonectomy, and there have been no reports of complete video-assisted thoracoscopic surgery （cVATS） for such a case. We present three cases of cVATS pneumonectomy. The operation method was based on four ports, and ports were added in difficult cases. In these cases, the blood loss and length of surgery were similar to results of VATS reported previously. We experienced bleeding complications in one case but were able to manage appropriately. There were no serious postoperative complications in our cases. In addition, it was considered acceptable in terms of safety because there were no deaths within 30 days after operation in all cases. The cVATS pneumonectomy for lung cancer is one of the useful treatment option because of safety and many benefits although the long-term results are unknown at present.