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胸腔外科的当前趋势。

Current trends in thoracic surgery.

机构信息

Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

出版信息

Nagoya J Med Sci. 2020 May;82(2):161-174. doi: 10.18999/nagjms.82.2.161.

DOI:10.18999/nagjms.82.2.161
PMID:32581397
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7276403/
Abstract

Thoracic surgery has evolved drastically in recent years. Although thoracic surgeons mainly deal with tumorous lesion in the lungs, mediastinum, and pleura, they also perform lung transplantation surgery in patients with end-stage lung disease. Herein, we introduce various major current topics in thoracic surgery. Minimally invasive surgical procedures include robot-assisted thoracic surgery and uniportal video-assisted thoracic surgery. Novel techniques for sublobar resection include virtual-assisted lung mapping, image-guided video-assisted thoracic surgery, and segmentectomy using indocyanine green. Three-dimensional (3D) computed tomography (CT) simulation consists of surgeon-friendly 3D-CT image analysis systems and new-generation, dynamic 3D-CT imaging systems. Updates in cadaveric lung transplantation include use of marginal donors, including donation after circulatory death, and lung perfusion for such donors. Topics in living donor lobar lung transplantation include size matching, donor issues, and new surgical techniques. During routine clinical practice, thoracic surgeons encounter various pivotal topics related to thoracic surgery, which are described in this report.

摘要

近年来，胸外科发生了巨大的变化。尽管胸外科医生主要处理肺部、纵隔和胸膜的肿瘤病变，但他们也为终末期肺部疾病的患者进行肺移植手术。在此，我们介绍胸外科的各种主要当前课题。微创外科手术包括机器人辅助胸腔镜手术和单孔电视胸腔镜手术。亚肺叶切除术的新方法包括虚拟辅助肺绘图、图像引导电视胸腔镜手术和使用吲哚菁绿的节段切除术。三维（3D）计算机断层扫描（CT）模拟包括便于外科医生使用的 3D-CT 图像分析系统和新一代动态 3D-CT 成像系统。尸体肺移植的更新包括使用边缘供体，包括循环死亡后的捐献，以及此类供体的肺灌注。活体供体肺叶移植的课题包括大小匹配、供体问题和新的手术技术。在常规临床实践中，胸外科医生会遇到与胸外科相关的各种关键课题，本报告对此进行了描述。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a77/7276403/146e806bf55b/2186-3326-82-0161-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a77/7276403/c38bee4b1a37/2186-3326-82-0161-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a77/7276403/72f89ac829f7/2186-3326-82-0161-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a77/7276403/8c69f3e75f03/2186-3326-82-0161-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a77/7276403/dd7ea2dc99ad/2186-3326-82-0161-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a77/7276403/435943892473/2186-3326-82-0161-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a77/7276403/f58b9bce969c/2186-3326-82-0161-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a77/7276403/4171852ae397/2186-3326-82-0161-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a77/7276403/146e806bf55b/2186-3326-82-0161-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a77/7276403/c38bee4b1a37/2186-3326-82-0161-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a77/7276403/72f89ac829f7/2186-3326-82-0161-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a77/7276403/8c69f3e75f03/2186-3326-82-0161-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a77/7276403/dd7ea2dc99ad/2186-3326-82-0161-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a77/7276403/435943892473/2186-3326-82-0161-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a77/7276403/f58b9bce969c/2186-3326-82-0161-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a77/7276403/4171852ae397/2186-3326-82-0161-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a77/7276403/146e806bf55b/2186-3326-82-0161-g008.jpg

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