Eguchi Takashi, Sato Toshihiko, Shimizu Kimihiro
Division of General Thoracic Surgery, Department of Surgery, School of Medicine, Shinshu University, Matsumoto 390-8621, Japan.
Department of General Thoracic, Breast, Pediatric Surgery, Faculty of Medicine, Fukuoka University, Fukuoka 814-0180, Japan.
Cancers (Basel). 2021 Jun 23;13(13):3137. doi: 10.3390/cancers13133137.
With the increased detection of early-stage lung cancer and the technical advancement of minimally invasive surgery (MIS) in the field of thoracic surgery, lung segmentectomy using MIS, including video- and robot-assisted thoracic surgery, has been widely adopted. However, lung segmentectomy can be technically challenging for thoracic surgeons due to (1) complex segmental and subsegmental anatomy with frequent anomalies, and (2) difficulty in localizing deep, small, and impalpable tumors, leading to difficulty in obtaining adequate margins. In this review, we summarize the published evidence and discuss key issues related to MIS segmentectomy, focusing on preoperative planning/simulation and intraoperative tumor localization. We also demonstrate two of our techniques: (1) three-dimensional computed tomography (3DCT)-based resection planning using a novel 3DCT processing software, and (2) tumor localization using a novel radiofrequency identification technology.
随着早期肺癌检测率的提高以及胸外科领域微创手术（MIS）技术的进步，包括电视辅助胸腔镜手术和机器人辅助胸腔镜手术在内的MIS肺段切除术已被广泛应用。然而，肺段切除术对胸外科医生来说在技术上具有挑战性，原因如下：（１）段和亚段解剖结构复杂，常有变异；（２）难以定位深部、小且触不可及的肿瘤，导致难以获得足够的切缘。在本综述中，我们总结已发表的证据，并讨论与MIS肺段切除术相关的关键问题，重点关注术前规划/模拟和术中肿瘤定位。我们还展示了我们的两种技术：（１）使用新型三维计算机断层扫描（3DCT）处理软件基于3DCT的切除规划；（２）使用新型射频识别技术进行肿瘤定位。
