Sunder-Plassmann L, Liewald F, Orend K H
Abteilung Thorax- und Gefässchirurgie, Universitätsklinikum Ulm.
Chirurg. 2004 Apr;75(4):354-8. doi: 10.1007/s00104-004-0853-5.
Occasionally, thoracic interventions may require interdisciplinary teamwork with plastic surgery, heart and vascular surgery, or neurosurgery. Thoracic wall defects following excision of primary wall tumors or recurrent, ulcerating tumors of the breast may require full-thickness myocutaneous flaps, which can best be done with the help of plastic surgeons. In case of infiltration of the heart or thoracic aorta, the en bloc principle of T4 lung tumors occasionally requires the help of heart surgeons, for open atrial resection using the heart-lung machine, or vascular surgeons for aortic graft interposition. Paravertebral dumbbell tumors occasionally may infiltrate to the intraspinal space and therefore need removal by neurosurgeons. When and why other specialists are required for an interdisciplinary approach to diseases of the chest has not been clearly defined. Therefore it is wise to gain informed consent from the patient about the roles of different specialists in interdisciplinary treatment for his disease.
偶尔，胸部干预可能需要与整形外科、心脏和血管外科或神经外科进行跨学科团队合作。原发胸壁肿瘤切除术后或复发性、溃疡性乳腺肿瘤导致的胸壁缺损可能需要全层肌皮瓣修复，这最好在整形外科医生的帮助下完成。如果心脏或胸主动脉受到浸润，T4 肺癌肿瘤的整块切除原则有时需要心脏外科医生的协助，以使用体外循环机进行开放性心房切除术，或者需要血管外科医生进行主动脉移植介入。椎旁哑铃形肿瘤偶尔可能浸润至椎管内，因此需要神经外科医生进行切除。何时以及为何需要其他专科医生参与胸部疾病的跨学科治疗尚未明确界定。因此，明智的做法是就不同专科医生在其疾病跨学科治疗中的作用获得患者的知情同意。
