Yamataka Atsuyuki, Koga Hiroyuki, Ochi Takanori, Imashimizu Kota, Suzuki Kazuhiro, Kuwatsuru Ryohei, Lane Geoffrey, Nishimura Kinya, Inada Eiichi, Suzuki Kenji
Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan.
Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan.
Pediatr Surg Int. 2017 Apr;33(4):483-495. doi: 10.1007/s00383-016-4052-5. Epub 2016 Dec 31.
Thoracoscopic pulmonary lobectomy (TPL) techniques in infants and children are presented practically with concise descriptions and numerous illustrations. TPL is the treatment of choice for congenital pulmonary airway malformation and intralobar pulmonary sequestration, both now commonly diagnosed prenatally. Timing of surgery is somewhat controversial in asymptomatic cases with small isolated lesions. Incomplete fissures and history of chest infections are most problematic. Thorough understanding of anatomic relations preoperatively is vital for successful outcome and thin-slice computed tomography with 3D reconstruction of vessels is valuable. Judicious placement of trocars and switching instruments between trocars improves visualization and safety. Specific techniques for all commonly performed TPL are included.
本文通过简洁的描述和大量插图，实际展示了婴幼儿的胸腔镜肺叶切除术（TPL）技术。TPL是先天性肺气道畸形和叶内型肺隔离症的首选治疗方法，目前这两种疾病通常在产前被诊断出来。对于无症状的小孤立病变病例，手术时机存在一定争议。不完全肺裂和胸部感染史是最棘手的问题。术前全面了解解剖关系对于取得成功的手术结果至关重要，而薄层计算机断层扫描及血管三维重建很有价值。明智地放置套管针并在套管针之间切换器械可改善视野并提高安全性。文中还包括了所有常见TPL手术的具体技术。
