心脏手术后正中开胸后的电视辅助胸腔镜手术

Video-Assisted Thoracic Surgery After Median Sternotomy for Cardiac Surgery.

作者信息

Serna-Gallegos Derek, Merry Heather, McKenna Robert J

机构信息

Division of Thoracic Surgery, Department of Surgery, Cedars-Sinai Medical Center, 8631 West Third, Suite 240E, Los Angeles, CA 90048, USA.

出版信息

Thorac Surg Clin. 2015 Aug;25(3):349-54. doi: 10.1016/j.thorsurg.2015.04.004.

DOI:10.1016/j.thorsurg.2015.04.004

PMID:26210930

Abstract

Video-assisted thoracic surgery (VATS) lobectomy has become a standard approach for early stage 1 lung cancer. However, concerns still remain regarding certain clinical situations, such as potential damage to the heart or bypass grafts when VATS is performed after median sternotomy for cardiac surgery. In this article, techniques are described to minimize risk to an internal mammary artery graft during a VATS anatomic pulmonary resection in this group of patients. The article reviews data on VATS after median sternotomy for cardiac surgery and describes techniques to prevent, treat, and mitigate problems in this group of patients. Management of intraoperative crises is also discussed.

摘要

电视辅助胸腔镜手术（VATS）肺叶切除术已成为早期I期肺癌的标准治疗方法。然而，对于某些临床情况仍存在担忧，例如在心脏手术后正中胸骨切开术后进行VATS时，可能对心脏或旁路移植物造成损伤。在本文中，描述了在这类患者进行VATS解剖性肺切除术中尽量减少对胸廓内动脉移植物风险的技术。本文回顾了心脏手术后正中胸骨切开术后VATS的数据，并描述了预防、治疗和减轻这类患者问题的技术。还讨论了术中危机的处理。