White Abby, Swanson Scott J
Division of Thoracic Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA -
Minerva Chir. 2016 Feb;71(1):61-6. Epub 2015 Nov 6.
The role of video-assisted thoracic surgery (VATS) in the treatment of lung cancer is well established. However a topic of current debate centers on the role of parenchymal-sparing operations, segmentectomy in particular, in the treatment of non-small cell lung cancer (NSCLC). Current reports in the literature draw dramatically different conclusions regarding the efficacy and safety of segmentectomy versus lobectomy for NSCLC. Two randomized controlled trials are currently underway to shed further light on this topic. Lobectomy remains the standard of care, with VATS approaches demonstrating improved morbidity. Experience in literature suggests segmentectomy is a viable approach for patients with limited cardiopulmonary reserve, or who would otherwise be unable to tolerate lobectomy. Thus, VATS segmentectomy is a vital skill in the armamentarium of today's thoracic surgeon. Minimally invasive approaches to segmentectomy are accomplished with a certain amount of finesse and a thorough understanding of the associated anatomy. A technical description of VATS segmentectomy is provided.
电视辅助胸腔镜手术（VATS）在肺癌治疗中的作用已得到充分确立。然而，当前争论的一个话题集中在保留实质组织手术，尤其是肺段切除术，在非小细胞肺癌（NSCLC）治疗中的作用。文献中的当前报告对于NSCLC肺段切除术与肺叶切除术的疗效和安全性得出了截然不同的结论。目前正在进行两项随机对照试验，以进一步阐明这一话题。肺叶切除术仍然是标准的治疗方法，VATS手术方式显示出发病率有所改善。文献中的经验表明，肺段切除术对于心肺储备有限或否则无法耐受肺叶切除术的患者是一种可行的方法。因此，VATS肺段切除术是当今胸外科医生必备技能中的一项重要技能。微创肺段切除术需要一定的技巧以及对相关解剖结构的透彻理解。本文提供了VATS肺段切除术的技术描述。
