Nomori H, Horio H, Suemasu K
Department of Thoracic Surgery, Saiseikai Central Hospital, Tokyo, Japan.
Jpn J Thorac Cardiovasc Surg. 2000 Feb;48(2):135-8. doi: 10.1007/BF03218109.
The patient was a 65-year-old female with metastasis of thyroid papillary carcinoma at the right upper mediastinum. The tumor, which invaded almost the entire length of the right brachiocephalic vein, was resected via a modified trap-door thoracotomy. The modification was the additional resection of the first rib from inside the thorax, which provided a sufficient exposure from the distal side of the brachiocephalic and subclavian vein. Because the subclavian and internal jugular veins could be clamped under this thoracotomy, the entire right brachiocephalic vein could be reconstructed by graft without excessive difficulty. Modified trap-door thoracotomy is a useful approach in the resection of malignancies which invade the brachiocephalic and subclavian vein.
该患者为65岁女性，甲状腺乳头状癌转移至右上纵隔。肿瘤几乎侵犯了右头臂静脉的全长，通过改良的活板门开胸术进行切除。改良之处在于从胸腔内额外切除第一肋骨，这从臂头静脉和锁骨下静脉的远端提供了足够的暴露。由于在此开胸术下可夹闭锁骨下静脉和颈内静脉，整个右头臂静脉可通过移植进行重建，且不会有过多困难。改良活板门开胸术是切除侵犯臂头静脉和锁骨下静脉的恶性肿瘤的一种有用方法。
