Guido William, Gonzalez-Rivas Diego, Duang Liang, Yang Yang, Li Wentao, Jiang Gening
Department of Thoracic Surgery, Rafael Angel Calderon Guardia Hospital, San José, Costa Rica.
Department of Thoracic Surgery, Coruña University Hospital and Minimally Invasive Thoracic Surgery Unit (UCTMI), Coruña, Spain.
J Vis Surg. 2015 Aug 7;1:10. doi: 10.3978/j.issn.2221-2965.2015.07.05. eCollection 2015.
The development of minimally invasive thoracic surgery in recent years is undeniable, VATS has evolved from the conventional three-port technique to an uniportal approach, without compromising the type of cases that can be operated successfully.
Thanks to the continuous progress of uniportal video-assisted thoracoscopic surgery (VATS) the complexity of cases performed by this approach has improved remarkably since the first procedures were made, recent advances in surgical thoracoscopic technology had made feasible to achieve vascular and bronchial sleeve lobectomies. Anatomic variants in patients can increase the technical difficulty of the procedure making the process more challenging.
In this case the sleeve right upper lobectomy was performed by uniportal VATS despite the obstruction of the right pulmonary artery (PA) for the bronchial anastomosis.
In the hands of experienced surgeons in uniportal VATS with background in thoracoscopic suturing, sleeve lobectomies are feasible and safe to perform even when anatomic variants increase the complexity of the case.
近年来微创胸外科的发展是不可否认的，电视辅助胸腔镜手术（VATS）已从传统的三孔技术发展为单孔入路，且不影响能够成功进行手术的病例类型。
得益于单孔电视辅助胸腔镜手术（VATS）的不断进步，自首次开展该手术以来，通过这种方法进行的病例复杂性有了显著提高，外科胸腔镜技术的最新进展使得实现血管和支气管袖状肺叶切除术成为可能。患者的解剖变异会增加手术的技术难度，使手术过程更具挑战性。
在本病例中，尽管右肺动脉（PA）存在梗阻用于支气管吻合，但仍通过单孔VATS进行了袖状右上肺叶切除术。
在有胸腔镜缝合背景的单孔VATS经验丰富的外科医生手中，即使解剖变异增加了病例的复杂性，袖状肺叶切除术的实施也是可行且安全的。
