Kawahara Katsunobu
Oita University Faculty of Medicine, Department of Onchological Science, Surgery II, Oita, Japan.
Nihon Geka Gakkai Zasshi. 2005 Jun;106(6):390-4.
Recently, small peripheral lung cancers which is indicated limited resection are frequently found by HRCT or PET. The limited resection for lung cancer includes thoracic and video-assisted anatomical segmentectomy (VATS segmentectomy) and wedge resection of the lung parenchyma. In anatomical segmentectomy, intra-plumonary lymph nodes are dissected, on the other hand, those lymph nodes can not be dissected in wedge resection. Consequently, segmentectomy will be radical procedure for lung cancer compared with wedge resection. Thoracic surgeons are required to perform anatomical segmentectomy for small peripheral lung cancer. The anatomical segmentectomy is not familiar procedure for recent thoracic surgeons. Thoracic surgeons should be skilled in that procedures. This is a review of basic procedures of VATS segmentectomy for lung cancer for young thoracic surgeones.
近年来,通过高分辨率计算机断层扫描(HRCT)或正电子发射断层显像(PET)常常能发现适合进行局限性切除的周围型小肺癌。肺癌的局限性切除包括开胸手术和电视辅助解剖性肺段切除术(VATS肺段切除术)以及肺实质楔形切除术。在解剖性肺段切除术中,肺内淋巴结会被清扫,而在楔形切除术中则无法清扫这些淋巴结。因此,与楔形切除术相比,肺段切除术对肺癌而言是一种根治性手术。胸外科医生需要为周围型小肺癌实施解剖性肺段切除术。解剖性肺段切除术对于当代胸外科医生来说并非常用手术方式。胸外科医生应当熟练掌握该手术。这是一篇针对年轻胸外科医生的VATS肺癌肺段切除术基本操作的综述。