Thoracic Surgery Department, Nottingham University Hospitals, Hucknall Road, Nottingham, NG5 1PB, UK.
Multimed Man Cardiothorac Surg. 2021 Mar 9;2021. doi: 10.1510/mmcts.2021.017.
The thoracotomy incision is essential for many thoracic surgery procedures. A number of different variations exist, and different techniques can be used, depending both on the patient and on the technical factors. The muscle-sparing technique was first described by Noirclerc et al. in 1973. [1] Initially, it was thought that preservation of the muscular structures compared with the results of a traditional posterolateral thoracotomy, in which the latissimus dorsi and sometimes the serratus anterior are often divided, would benefit long-term outcomes. However, subsequent study results have not demonstrated any difference in postoperative outcomes. The unequivocal benefit of a muscle-sparing approach is to preserve the latissimus dorsi for any future intervention, such as a procedure involving the chest wall and the intrathoracic flaps. In this video tutorial, we describe our approach to this commonly used incision, including the anatomy and the technical aspects used to provide optimal operative exposure and minimal postoperative complications while preserving the underlying musculature.
胸腔切开术对于许多胸外科手术程序至关重要。存在许多不同的变化，并且可以根据患者和技术因素使用不同的技术。肌保留技术最初由 Noirclerc 等人于 1973 年描述。[1]最初，人们认为与传统的后外侧开胸术（其中通常会切开背阔肌和有时前锯肌）相比，保留肌肉结构会有益于长期结果。然而，随后的研究结果并未表明术后结果有任何差异。肌保留方法的明确益处是为任何未来的干预保留背阔肌，例如涉及胸壁和胸内皮瓣的手术。在本视频教程中，我们描述了我们对这种常用切口的方法，包括解剖结构和技术方面，这些方面可以提供最佳的手术暴露效果，同时将术后并发症最小化，同时保留潜在的肌肉。
