Miyahara Shunsuke, Inoue Takeshi, Minami Hitoshi, Okada Kenji, Okita Yutaka
Division of Cardiovascular Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Surg Today. 2014 May;44(5):972-5. doi: 10.1007/s00595-013-0537-1. Epub 2013 Mar 7.
Midsternotomy in patients with a coexisting tracheostomy is associated with a risk of deep sternal wound infection (DSWI) or mediastinitis. We herein present two cases of total arch replacement using a surgical technique designed to avoid the danger of DSWI. Total arch replacement via an antero-lateral thoracotomy with partial sternotomy can be one of the options for patients with a tracheostoma or after laryngectomy, and can both protect organs and avoid DSWI.
对于同时存在气管造口术的患者,正中胸骨切开术与深部胸骨伤口感染(DSWI)或纵隔炎风险相关。我们在此介绍两例采用旨在避免DSWI危险的手术技术进行全弓置换的病例。通过前外侧开胸术加部分胸骨切开术进行全弓置换可以作为气管造口患者或喉切除术后患者的选择之一,既能保护器官又能避免DSWI。