Abu Akar Firas, Yang Chenlu, Lin Lei, Min Shi Jia, Jiang Lei
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China.
Department of Cardiothoracic Surgery, Shaare Zedek Medical Center (SZMC), Jerusalem, Israel.
J Vis Surg. 2017 Apr 10;3:51. doi: 10.21037/jovs.2017.03.07. eCollection 2017.
The importance of parenchymal tissue preservation during lung resections is well realized in thoracic surgery. Technical refinement and anatomic insight have expanded indications for parenchymal -sparing surgeries. In thoracic surgery, it's reasonable to avoid pneumonectomy whenever it's possible, although challenging and technically more demanding than standard anatomic pulmonary resection, bronchial and/or vascular resection of a circumferential portion (sleeve resections) is a justified procedure due to its benefits of avoiding the complications of pneumonectomy in addition to preservation of pulmonary tissue and functions. In The era of video assisted thoracoscopic surgery's revolution and with the improvement of the surgical instruments and surgeon's experience, reports on multiportal and uniportal sleeve and double sleeve resections published recently in the literature. Here we present a video documented case of the Intra-pericardial double sleeve left upper lobectomy that demonstrates our technique in performing this surgery via uniportal approach.
在胸外科手术中,肺切除术中保留实质组织的重要性已得到充分认识。技术的改进和解剖学认识的深入扩大了保留实质组织手术的适应症。在胸外科手术中,只要有可能,避免全肺切除术是合理的,尽管这比标准的解剖性肺切除术更具挑战性且技术要求更高,但对圆周部分进行支气管和/或血管切除(袖状切除术)是一种合理的手术方式,因为它除了能保留肺组织和功能外,还能避免全肺切除术的并发症。在电视辅助胸腔镜手术革命的时代,随着手术器械的改进和外科医生经验的积累,文献中最近发表了关于多端口和单端口袖状及双袖状切除术的报道。在此,我们展示一例心包内双袖状左上肺叶切除术的视频记录病例,展示我们通过单端口入路进行该手术的技术。