Division of General Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
Surg Today. 2012 Jan;42(1):104-6. doi: 10.1007/s00595-011-0025-4. Epub 2011 Nov 11.
We describe our innovative technique for performing segmentectomy of the posterior segment of the lower lobe of the lung, being segment number 10 (S¹⁰). In segmentectomy of S¹⁰, it is difficult to identify A¹⁰ from the interlobar fissure because the pulmonary artery to S¹⁰ (A¹⁰) branches from A(9+10) and runs dorsally and deeply into the lung tissue. Moreover, to reach S¹⁰ from the interlobar fissure, the lung tissue should be cut between S⁶ and S⁸, because S¹⁰ is not located beside the interlobar fissure. However, it is difficult to identify the boundary between the S⁶ and S⁸ without a route marker. To solve these difficulties, we divided S⁶ and S¹⁰ from each other at the beginning of the procedure, which enabled A¹⁰ to be identified easily from the dorsal side. Because S⁶ and S(8-10) should be divided in S¹⁰ segmentectomy at the end, the division between S⁶ and S(8-10) at the beginning of procedure is not only reasonable, but makes the procedure simple.
我们描述了一种创新性的技术，用于进行肺下叶后段（第 10 段）的节段切除术。在第 10 段节段切除术中，由于第 10 段的肺动脉（A¹⁰）从 A(9+10)分支出来，并且向背部和深部延伸到肺组织中，因此从叶间裂很难识别 A¹⁰。此外，为了从叶间裂到达第 10 段，肺组织应该在 S⁶ 和 S⁸ 之间切开，因为第 10 段不在叶间裂旁边。然而，由于没有路径标记，很难识别 S⁶ 和 S⁸ 之间的边界。为了解决这些困难，我们在手术开始时将 S⁶ 和 S¹⁰分开，这样就可以从背部轻松识别 A¹⁰。由于在第 10 段节段切除术中需要在最后分开 S⁶ 和 S(8-10)，因此在手术开始时将 S⁶ 和 S(8-10)分开不仅合理，而且使手术变得简单。
