Wang Fuqiang, Zhang Hanlu, Zheng Yu, Wang Yun
Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China.
Transl Cancer Res. 2021 Jan;10(1):195-200. doi: 10.21037/tcr-19-1492.
Massive intraoperative bleeding resulted from vascular injury during the dissection of pulmonary vessel in minimally invasive lobectomy is a troublesome and dangerous surgical scenario. It is reported that vascular injury result in 29-45% of incidences of conversion to thoracotomy in minimally invasive pulmonary surgery. In this paper, we introduce a guiding tube created from two-way Foley catheter for robotic pulmonary resection in attempting to avoid vascular injury when passing linear stapler.
From July 2018 to June 2019, this guiding method was adopted in patients who underwent robot-assisted thoracoscopic surgery lobectomy. The technical details and short-term outcomes are described in this paper.
A total of 31 patients were successfully treated with robotic pulmonary resection with help of the guiding method presented in this study. The median surgical time was 180 min and the median loss of blood was 100 mL. Only one patient was converted to open thoracotomy for silicoanthracotic lymph nodes adhered in hilum of lung. The median length of hospital stay was 5 days. There was no mortality in 30 days after hospital discharge.
This modified Foley catheter seems to be a promising guiding method to avoid vascular injury when passing linear stapler in robotic pulmonary resection.
在微创肺叶切除术中,肺血管解剖过程中的血管损伤导致大量术中出血是一种棘手且危险的手术情况。据报道,在微创肺部手术中,血管损伤导致中转开胸的发生率为29% - 45%。在本文中,我们介绍一种由双腔 Foley 导管制成的引导管,用于机器人肺切除术,试图在使用直线缝合器时避免血管损伤。
2018年7月至2019年6月,对接受机器人辅助胸腔镜手术肺叶切除术的患者采用这种引导方法。本文描述了技术细节和短期结果。
本研究提出的引导方法共成功治疗31例机器人肺切除术患者。中位手术时间为180分钟,中位失血量为100毫升。仅1例患者因肺门处硅沉着性淋巴结粘连而中转开胸。中位住院时间为5天。出院后30天内无死亡病例。
这种改良的 Foley 导管似乎是一种有前景的引导方法,可在机器人肺切除术中使用直线缝合器时避免血管损伤。