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经单孔电视辅助胸腔镜手术(UVATS)行右肺下叶切除术治疗 T4 期巨大鳞癌。

Uniportal video-assisted thoracoscopic surgery (UVATS) right lower lobectomy for a giant T4 squamous cell lung tumour.

机构信息

Department of Cardiothoracic and Vascular Surgery, Rania Medical City Hospital, Rania, Sulaimani, Kurdistan-region, Iraq.

Department of Cardiac Care Unit, Rania Teaching Hospital, Rania, Sulaimani, Kurdistan-region, Iraq.

出版信息

J Int Med Res. 2022 Apr;50(4):3000605221097374. doi: 10.1177/03000605221097374.

Abstract

Video-assisted thoracoscopic surgery (VATS) is one of the unique methods that have revolutionized the discipline of minimally-invasive thoracic surgery in the last two decades. Previously, double-port VATS lobectomy has been used for the resection of T4 tumours. This current case report presents a 68-year-old male that presented with a productive cough of 3 months' duration, associated with fever, chest pain and loss of body weight. He was haemodynamically stable. The patient underwent surgery under general anaesthesia using a uniportal VATS (UVATS) approach. A 2-cm incision was made in the mid-axillary line through the right 5th intercostal space with no rib spreading. The tumour was put into a specimen bag, cut into pieces and then removed via the mouth of the bag using a grasper. After good haemostasis, a single chest drain was placed and the small incision was sutured in layers. The postoperative course was uneventful and no complications were observed. On the 6th day postoperative, the patient was discharged home. This current case demonstrated that UVATS resection for T4 tumours might be a viable approach in the hands of skilled surgeons. It should also provide decreased postoperative pain, faster recovery and shorter hospitalization.

摘要

电视辅助胸腔镜手术 (VATS) 是过去二十年中微创胸外科领域的一项独特方法,它彻底改变了这一领域。以前,双端口 VATS 肺叶切除术用于切除 T4 肿瘤。本病例报告介绍了一名 68 岁男性,他因持续 3 个月的咳嗽、发热、胸痛和体重减轻而就诊。他血流动力学稳定。患者在全身麻醉下接受手术,采用单端口胸腔镜手术 (UVATS) 方法。在腋中线第 5 肋间做一个 2cm 的切口,不撑开肋骨。将肿瘤放入标本袋中,切成小块,然后用抓钳通过袋口取出。彻底止血后,放置单根胸腔引流管,并分层缝合小切口。术后过程顺利,无并发症发生。术后第 6 天,患者出院回家。本病例表明,熟练的外科医生采用 UVATS 切除 T4 肿瘤可能是一种可行的方法。它还应提供减轻术后疼痛、更快的恢复和更短的住院时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f9d/9087254/90b0c1f9b3c4/10.1177_03000605221097374-fig1.jpg

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