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机器人辅助左肺段切除术治疗原发性肺癌伴不完全肺裂:病例报告。

Fissureless technique of robotic left lingular segmentectomy for primary lung cancer with incomplete fissure: a case report.

机构信息

Department of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.

出版信息

J Cardiothorac Surg. 2023 Apr 11;18(1):125. doi: 10.1186/s13019-023-02211-7.

Abstract

BACKGROUND

Pulmonary segmentectomy for a lung with an incomplete interlobar fissure may complicate persistent air leakage. The fissureless technique is often used in lobectomy to prevent persistent air leakage. We herein describe successful use of the fissureless technique for segmentectomy with the aid of a robotic surgical system.

CASE PRESENTATION

A 63-year-old man was clinically diagnosed with early-stage lung cancer for which lingular segmentectomy was indicated. A preoperative image revealed a lung with an incomplete fissure. Based on three-dimensional reconstruction imaging, we planned to divide the hilum structures in the order of the pulmonary vein, bronchus, and pulmonary artery and finally resect the lung parenchyma by dividing the intersegmental plane and interlobar fissure. This fissureless technique was successfully conducted using a robotic surgical system. The patient did not develop persistent air leakage and was alive without recurrence 1 year after segmentectomy.

CONCLUSIONS

The fissureless technique may be a useful option in segmentectomy for a lung with an incomplete interlobar fissure.

摘要

背景

对于存在不完全叶间裂的肺,进行肺段切除术可能会导致持续性漏气。无裂法技术常用于肺叶切除术以预防持续性漏气。我们在此描述了在机器人手术系统辅助下,成功使用无裂法技术进行肺段切除术的经验。

病例介绍

一名 63 岁男性,临床诊断为早期肺癌,需要行舌段切除术。术前影像学检查显示存在不完全叶间裂的肺。基于三维重建图像,我们计划按肺静脉、支气管和肺动脉的顺序分离肺门结构,最后通过分离段间平面和叶间裂来切除肺实质。使用机器人手术系统成功实施了无裂法技术。患者未发生持续性漏气,且在肺段切除术后 1 年时仍然存活,无复发。

结论

对于存在不完全叶间裂的肺,无裂法技术可能是肺段切除术的一种有用选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f37d/10088251/8dfffa0deec1/13019_2023_2211_Fig1_HTML.jpg

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