Shiono Hiroyuki
General Thoracic Surgery, Kindai University Nara Hospital, Ikoma, Japan.
Mediastinum. 2022 Sep 25;6:24. doi: 10.21037/med-21-43. eCollection 2022.
For the purpose of facilitating a wide view and working space during surgery such as a thymectomy procedure, as well as that for treatment of anterior mediastinal lesions, anterior chest wall lifting began to be employed. In this article, previous reports of various kinds of chest wall lifting methods are reviewed.
The present study focused on procedures used for anterior chest wall lifting in a review of related studies primarily available in English. A search of the PubMed database was conducted in 1st March 2016. The first description about lifting method was reported in 1988.
Although objective evaluation regarding the effectiveness of lifting is difficult, in view of a balance among safety, reliability, and minimal invasiveness, surgeons may consider chest wall lifting as an optional method.
Anterior chest wall lifting began to be employed for enlarging the working space long before the advent of endoscopic surgery. Some originally developed retractors were used in transcervical thymectomy procedures. After general acceptance of transsternal extended thymectomy for myasthenia gravis, these transcervical approaches remained an important option along with anterior chest wall lifting. Thoracoscopic surgery for the treatment of anterior mediastinal lesions was introduced in the 1990s. Particularly in cases of surgery in the supine position, various creative methods and devices of lifting the sternum body, the anterior part of the rib, or the xiphoid process were reported.
为了在诸如胸腺切除术等手术过程中获得更广阔的视野和操作空间，以及用于治疗前纵隔病变，开始采用前胸壁提升术。本文回顾了以往各种胸壁提升方法的报道。
本研究主要通过检索英文相关研究，聚焦于前胸壁提升术所采用的手术步骤。于2016年3月1日检索了PubMed数据库。关于提升方法的首次描述于1988年被报道。
尽管难以对提升术的有效性进行客观评估，但鉴于安全性、可靠性和微创性之间的平衡，外科医生可将胸壁提升术视为一种可选择的方法。
前胸壁提升术早在内镜手术出现之前就开始用于扩大操作空间。一些最初研发的牵开器曾用于经颈部胸腺切除术中。在全胸骨延伸胸腺切除术被广泛用于治疗重症肌无力之后，这些经颈部手术入路以及前胸壁提升术仍然是重要的选择。20世纪90年代引入了胸腔镜手术用于治疗前纵隔病变。特别是在仰卧位手术的病例中，报道了各种提升胸骨体、肋骨前部或剑突的创新方法和器械。
