Gonzalez-Rivas Diego, Fernandez Ricardo, de la Torre Mercedes, Martin-Ucar Antonio E
Minimally Invasive Thoracic Surgery Unit (UCTMI), Coruña, Spain.
Multimed Man Cardiothorac Surg. 2012 Jan 1;2012:mms007. doi: 10.1093/mmcts/mms007.
Over the past two decades, video-assisted thoracic surgery (VATS) has revolutionized the way thoracic surgeons diagnose and treat lung diseases. The major advance in VATS procedures is related to the major pulmonary resections. The optimal VATS technique for lobectomy in lung cancer has not been well defined yet. Most of the authors describe the VATS approach to lobectomy via three to four incisions, but the surgery can be performed by only one incision with similar outcomes. This single incision is the same as we normally use for VATS lobectomies performed by double- or triple-port technique, with no rib spreading. As our experience with VATS lobectomy has grown, we have gradually improved the technique for a less-invasive approach. Consequently, the greater the experience we gained, the more complex the cases we performed were, thus expanding the indications for single-incision thoracoscopic lobectomy.
在过去二十年中,电视辅助胸腔镜手术(VATS)彻底改变了胸外科医生诊断和治疗肺部疾病的方式。VATS手术的主要进展与主要肺切除术有关。肺癌肺叶切除术的最佳VATS技术尚未明确界定。大多数作者描述了通过三到四个切口进行VATS肺叶切除术的方法,但该手术也可以通过单一切口进行,且效果相似。这个单一切口与我们通常用于双端口或三端口技术的VATS肺叶切除术相同,无需撑开肋骨。随着我们VATS肺叶切除术经验的积累,我们逐渐改进了技术以实现更微创的方法。因此,我们获得的经验越多,所进行的病例就越复杂,从而扩大了单切口胸腔镜肺叶切除术的适应症。