Department of Thoracic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Thorac Cancer. 2018 Nov;9(11):1562-1564. doi: 10.1111/1759-7714.12864. Epub 2018 Sep 17.
Segmentectomy is a widely adopted surgical procedure, however, experiences of tailoring the intersegmental border have rarely been reported. This paper investigates the strategy and results of tailoring complex demarcation during lung segmentectomy surgery. Because intersegmental demarcation can be divided into plane or curved types according to the location and stereo shape of a segment, a one-size-fits-all method for tailoring the intersegmental demarcation is obviously unreasonable. For tailoring a complex segmentectomy with two or more curved borders, tips including good exposure of the intersegmental demarcation, sharp-blunt combined dissection skill, "work-plane" extension, and "gate" opening techniques all contribute to an accurate segmentectomy. This technique, based on anatomical characteristics, can provide a cutting surface with a greater physiological shape and less curling of the edge, and should be recommended as a general standard method for tailoring complex demarcation.
段切除术是一种广泛采用的手术方法,然而,定制节段间边界的经验很少有报道。本文研究了在肺段切除术中定制复杂边界的策略和结果。由于节段间的分界线可以根据节段的位置和立体形状分为平面或曲面类型,因此一刀切的节段间分界线定制方法显然是不合理的。对于定制两个或更多弯曲边界的复杂段切除术,包括良好暴露节段间分界线的技巧、锐钝结合的解剖技巧、“工作平面”延伸和“门”开启技术等,都有助于实现准确的段切除术。这种基于解剖学特征的技术可以提供一个具有更大生理形状和边缘卷曲较少的切割面,应该被推荐为定制复杂边界的一般标准方法。