Morikawa T, Sugiura H, Kaji M, Sasamura Y, Okushiba S, Kondo S, Katoh H, Ishitani T, Mayumi T, Watanabe H
Surgical Oncology, Division of Cancer Medicine, Anesthesiology, and Critical Care Medicine, and Second Department of Surgery, Hokkaido University Hospital, North 15, West 7, Kita-ku, Sapporo 060-8638, Japan.
Surg Endosc. 2002 Feb;16(2):327-30. doi: 10.1007/s00464-001-0024-4. Epub 2001 Nov 12.
Stable oxygenation and sufficient collapse of the lung are essential for video-assisted thoracic surgery (VATS). We performed the lobe-selective lung collapse technique with VATS for patients who had deteriorated lung function.
CASE 1: A 75-year-old man who had undergone thoracoplasty showed spontaneous pneumothoraces in the contralateral side. Bullae were stapled successfully under complete isolation and collapse of diseased lobe. CASE 2: A 57-year-old woman who had undergone left lower lobectomy for lung cancer presented with another lung cancer in the right lower lobe. The right lower lobe bronchus was closed selectively, and basal segmentectomy was performed. CASE 3: A 60-year-old woman who had lost left lung function presented with right-side spontaneous pneumothoraces. The right upper lobe was collapsed selectively, and bullectomy was performed.
Lobe-selective bronchial blockade may be beneficial when VATS is performed for selected patients with deteriorated lung function.
稳定的氧合和肺的充分萎陷对于电视辅助胸腔镜手术（VATS）至关重要。我们对肺功能恶化的患者采用VATS进行肺叶选择性萎陷技术。
病例1：一名75岁接受过胸廓成形术的男性对侧出现自发性气胸。在病变肺叶完全隔离和萎陷的情况下成功缝合肺大疱。病例2：一名57岁因肺癌接受左肺下叶切除术的女性右肺下叶出现另一个肺癌。选择性闭合右下叶支气管，并进行基底段切除术。病例3：一名60岁左肺功能丧失的女性出现右侧自发性气胸。选择性萎陷右上叶，并进行肺大疱切除术。
对于选定的肺功能恶化患者进行VATS时，肺叶选择性支气管封堵可能有益。
