Hirji Sameer A, Balderson Scott S, Berry Mark F, D'Amico Thomas A
1 Department of Surgery, Division of Thoracic Surgery, Duke University Medical Center, Durham, NC, USA ; 2 Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, USA.
Ann Cardiothorac Surg. 2015 Nov;4(6):545-9. doi: 10.3978/j.issn.2225-319X.2015.07.04.
Video-assisted thoracoscopic surgery (VATS) lobectomy is safe, oncologically effective, and increasingly utilized for lung cancer resection. Lessons from VATS lobectomy experience can guide the use of a VATS approach to resect mediastinal masses. Exposure and dissection when using VATS to resect anterior mediastinal masses has unique challenges. Several maneuvers acquired from experience with VATS lobectomy can reduce the technical difficulty and often prevent conversion to an open approach. In this troubleshooting guide, we offer 'tips' to both avoid and manage numerous intra-operative technical difficulties that commonly arise during VATS anterior mediastinal procedures. Avoiding an open approach may improve outcomes, although conversion for safety or complete resection can be necessary. Techniques and experiences derived from VATS lobectomy can facilitate VATS resection of mediastinal masses.
电视辅助胸腔镜手术（VATS）肺叶切除术是安全的，具有肿瘤学疗效，并且越来越多地用于肺癌切除。VATS肺叶切除术的经验教训可指导采用VATS方法切除纵隔肿物。使用VATS切除前纵隔肿物时的暴露和解剖具有独特的挑战。从VATS肺叶切除术经验中获得的几种操作方法可以降低技术难度，并常常能避免转为开放手术。在本故障排除指南中，我们提供“小贴士”，以避免和处理VATS前纵隔手术中常见的许多术中技术难题。避免采用开放手术可能会改善治疗效果，不过必要时为了安全或实现完整切除而转为开放手术也是可行的。源自VATS肺叶切除术的技术和经验有助于VATS切除纵隔肿物。
