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胸腔镜解剖性肺段切除术的规划与标记

Planning and marking for thoracoscopic anatomical segmentectomies.

作者信息

Seguin-Givelet Agathe, Grigoroiu Madalina, Brian Emmanuel, Gossot Dominique

机构信息

Thoracic Department, Curie-Montsouris Thorax Institute, Institut Mutualiste Montsouris, Paris, France.

Paris 13 University, Sorbonne Paris Cité, Faculty of Medicine SMBH, Bobigny, France.

出版信息

J Thorac Dis. 2018 Apr;10(Suppl 10):S1187-S1194. doi: 10.21037/jtd.2018.02.21.

Abstract

Although sublobar resection (SLR) for treating non-small cell lung carcinoma (NSCLC) is still controversial, thoracoscopic segmentectomy is rising. Performing it by closed chest surgery is complex as it means confirming the location of the lesion, identifying vascular and bronchial structures, preserving venous drainage of adjacent segments, severing the intersegmental plane and ensuring an oncological safety margin with no manual palpation and different landmarks. Accurate planning is mandatory. We discuss in this article the interest of 3D reconstruction and mapping technics to enhance safety and reliability of these procedures.

摘要

尽管亚肺叶切除术(SLR)治疗非小细胞肺癌(NSCLC)仍存在争议,但胸腔镜肺段切除术正在兴起。通过胸腔镜手术进行该操作很复杂,因为这意味着要确认病变位置、识别血管和支气管结构、保留相邻肺段的静脉引流、切断肺段间平面,并在没有手动触诊和不同解剖标志的情况下确保肿瘤学安全切缘。精确的规划是必不可少的。我们在本文中讨论三维重建和定位技术在提高这些手术的安全性和可靠性方面的作用。

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