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钝性胸部创伤后稳定胸壁膈肌的微创技术:“上提法”

A minimally invasive technique for stabilizing the diaphragm on the thoracic wall after blunt chest trauma: the "lifting-up method".

作者信息

Kamiyoshihara Mitsuhiro, Igai Hitoshi, Kawatani Natsuko, Ibe Takashi

机构信息

Department of General Thoracic Surgery, Maebashi Red Cross Hospital, 3-21-36 Asahi-cho, Maebashi, Gunma, 371-0014, Japan.

出版信息

Surg Today. 2016 Jul;46(7):872-5. doi: 10.1007/s00595-015-1249-5. Epub 2015 Sep 21.

Abstract

Most traumatic diaphragmatic tears are located centrally or radially and may be amenable to repair by direct suturing or suturing with a surgical patch. However, diaphragmatic tears, such as those immediately adjacent to the costal margin, are uncommon. We describe how we repaired this type of tear using a needle loop retractor to pass a 2-0 braided suture through the chest wall on both sides of the rib to suture the torn diaphragm to the chest wall. Our technique is more physiologically and anatomically consistent than previously reported techniques. We have termed this technique the "lifting-up method", which we believe to be an easy and useful technique for repairing traumatic diaphragmatic injuries with no seam allowance.

摘要

大多数创伤性膈肌撕裂位于中央或呈放射状,可通过直接缝合或用手术补片缝合进行修复。然而,如紧邻肋缘的膈肌撕裂并不常见。我们描述了如何使用针环牵开器将一根2-0编织缝线穿过肋骨两侧的胸壁,将撕裂的膈肌缝合到胸壁,以此修复此类撕裂。我们的技术在生理和解剖学上比先前报道的技术更为一致。我们将此技术称为“提起法”,我们认为这是一种修复创伤性膈肌损伤的简便实用技术,且无需预留缝合余量。

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