Fry W A, Kehoe T J, McGee J P
Section of Thoracic Surgery, and Evanston Hospital, Northwestern University Medical School, Illinois.
Am Surg. 1990 Aug;56(8):460-2.
The axillary thoracotomy should be the incision of choice for most uncomplicated general thoracic surgical procedures. It can be performed rapidly, avoids major muscle transection, and by employing a double lumen endotracheal tube will permit segmental resection as well as lobectomy without technical problem. One hundred consecutive, elective axillary thoracotomies were performed with minimal morbidity and only one mortality. Twenty-five of the patients were of high surgical risk. The larger posterolateral thoracotomy is reserved for repeat thoracotomy, Pancoast tumors, difficult procedures such as bronchoplasty and/or radical pneumonectomy, and when pleural symphysis is expected. Sometimes called lateral thoracotomy or mini-thoracotomy, the axillary thoracotomy is our most common incision.
对于大多数无并发症的普通胸外科手术而言，腋下开胸术应是首选切口。它操作迅速，避免了 major muscle transection，并且通过使用双腔气管导管，可进行节段性切除以及肺叶切除术，不存在技术问题。连续进行了100例择期腋下开胸术，发病率极低，仅1例死亡。其中25例患者手术风险较高。较大的后外侧开胸术则用于再次开胸、潘科斯特瘤、诸如支气管成形术和/或根治性肺切除术等复杂手术，以及预期会发生胸膜粘连的情况。腋下开胸术有时也被称为侧胸开胸术或小开胸术，是我们最常用的切口。
