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经胸骨双侧开胸术治疗双侧肺部病变

[Trans-sternal bilateral thoracotomy for bilateral lung lesions].

作者信息

Ohata M, Omori K, Irako M, Kitamura K, Nakamura S, Ogasawara K, Sezai Y

机构信息

Second Department of Surgery, Nihon University School of Medicine, Tokyo, Japan.

出版信息

Nihon Geka Gakkai Zasshi. 1991 Jul;92(7):862-6.

PMID:1886598
Abstract

The trans-sternal bilateral thoracotomy had been used widely in the early days of cardiac surgery, but since the 1960's the median sternotomy has played a great part in open heart surgery. Recently, the simultaneous bilateral thoracotomy has been used for bilateral lung lesions such as bilateral giant bullae, bilateral pneumothoraces and bilateral metastatic lung tumors. Since 1965 we have performed 6 operations using trans-sternal bilateral thoracotomy for several bilateral lung lesions. The diseases which led to the use of the trans-sternal bilateral thoracotomy technique were 2 cases of bilateral simultaneous pneumothoraces and 4 cases of bilateral lung metastatic tumors. The ages of the patients ranged from 17 to 45 years old. The operative blood loss was between 100 and 810 gm. No case showed postoperative respiratory distress or severe thoracic pain. It would like to be pointed out that the trans-sternal bilateral thoracotomy is the most ideal approach for the multiple bilateral lung metastatic lesions which often invade the chest wall or diaphragm.

摘要

胸骨旁双侧开胸术在心脏外科手术早期曾被广泛应用,但自20世纪60年代以来,正中胸骨切开术在心脏直视手术中发挥了重要作用。近年来,同期双侧开胸术已用于双侧肺部病变,如双侧巨大肺大疱、双侧气胸和双侧肺转移瘤。自1965年以来,我们采用胸骨旁双侧开胸术对几例双侧肺部病变进行了6例手术。导致采用胸骨旁双侧开胸术技术的疾病有2例双侧同时性气胸和4例双侧肺转移瘤。患者年龄在17至45岁之间。术中失血量在100至810克之间。无一例出现术后呼吸窘迫或严重胸痛。需要指出的是,胸骨旁双侧开胸术是治疗常侵犯胸壁或膈肌的多发性双侧肺转移瘤的最理想方法。

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