Sahdev Nikhil, Punjabi Karan, Williams Luke, Peryt Adam, Coonar Aman, Aresu Giuseppe
St. George's University of London, Thoracic Surgery, Cranmer Terrace, London SW17 0RE, UK.
Royal Papworth Hospital NHS Foundation Trust, Thoracic Surgery, Papworth Rd, Cambridge CB2 0AY, UK.
J Surg Case Rep. 2020 Apr 6;2020(4):rjaa052. doi: 10.1093/jscr/rjaa052. eCollection 2020 Apr.
This is a report of a 31-year-old male refugee, who was admitted to Intensive Therapy Unit after being found in severe chest pain after escaping extreme torture from his home country. He was found to have four nails in his thorax. These were removed using a subxiphoid video-assisted thorascopic surgery (VATS) technique. This technique allowed excellent visualization of the right, left and anterior mediastinal part of the chest and therefore preventing damage or injury to surrounding structures. This was particularly useful in a complex case such as this. By avoiding an intercoastal incision and intercostal manipulation, our patient had limited pain post-procedure facilitating an earlier aggressive mobilization program with potential benefit in terms of improved lung expansion, reduction of atelectasis and lung infections. With the right training, the technical challenges of using the technique should be overcome and thus the benefits of subxiphoid VATS will be offered to a larger portion of thoracic surgical patients.
这是一份关于一名31岁男性难民的报告，他在逃离祖国遭受的极端折磨后，因严重胸痛被收入重症监护病房。发现他的胸部有四根钉子。这些钉子通过剑突下电视辅助胸腔镜手术（VATS）技术被取出。该技术能很好地观察胸部的右侧、左侧和前纵隔部分，从而防止对周围结构造成损伤。在这样复杂的病例中，这一点尤为有用。通过避免肋间切口和肋间操作，我们的患者术后疼痛有限，有利于早期积极的活动计划，这在改善肺扩张、减少肺不张和肺部感染方面可能有益。经过适当的培训，应能克服使用该技术的技术挑战，从而将剑突下VATS的益处提供给更多的胸外科患者。
