Department of Cardio-Thoracic Surgery Padua University Hospital, Via Giustiniani 1 Padua (PD), Italy.
Thoracic Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Via Giustiniani 2, 35128, Padova, Italy.
Multimed Man Cardiothorac Surg. 2020 Sep 25;2020. doi: 10.1510/mmcts.2020.051.
The thoracoscopic approach to lobectomy is now the gold standard in cases of pulmonary malignancies because it is associated with a significant reduction in both postoperative hospital stay and pain. Even in cases of complex resection, as in the case reported here, the procedure can be performed safely after careful pre-operative planning. This video tutorial describes our technique for the intrapericardial isolation of the left inferior pulmonary vein in a patient affected by a left lower lobe metastasis from a colonic carcinoma. The lesion was retracting the inferior vein to such an extent that an intrapericardial approach was required in order to obtain a radical resection. The operation was carried out using a 3-port technique to allow for safe and unhindered manipulation of the hilar structures and the parenchyma. The pericardial sac was easily opened and the feasibility of the procedure was readily confirmed. The patient made an uneventful recovery; specifically, we did not record any arrhythmia or hemodynamic instability. She was discharged home on the 4th postoperative day.
胸腔镜肺叶切除术现在是治疗肺部恶性肿瘤的金标准，因为它与术后住院时间和疼痛的显著减少有关。即使在复杂的切除病例中，如本例报告，在仔细的术前规划后，该手术也可以安全进行。本视频教程介绍了我们在一名患有结肠癌左肺下叶转移的患者中进行心包内左下肺静脉隔离的技术。病变使下静脉回缩到如此程度，以至于需要心包内入路才能进行根治性切除。该手术采用三孔技术进行，以确保安全和不受阻碍地处理肺门结构和实质。心包很容易打开，并且可以很容易地确认该手术的可行性。患者恢复顺利，没有记录到任何心律失常或血流动力学不稳定。她在术后第 4 天出院回家。
