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右肺下叶袖状切除术:详细技术与围手术期患者管理。

Right Lower Sleeve Lobectomy: Detailed Technique and Perioperative Patient Management.

机构信息

Department of Thoracic Surgery, Osaka Metropolitan University, Osaka, Osaka, Japan.

出版信息

Ann Thorac Cardiovasc Surg. 2024;30(1). doi: 10.5761/atcs.oa.24-00026.

Abstract

PURPOSE

This report reviews our experience with right lower sleeve lobectomy and describes our technique and approach to perioperative patient management.

METHODS

We retrospectively reviewed 11 patients who underwent right lower sleeve lobectomy for lung cancer. Surgical techniques and perioperative management were also investigated.

RESULTS

Bronchoplasty was performed using 4-0 absorbable monofilament sutures. The deepest portion was anastomosed using continuous sutures; interrupted sutures were used for the more superficial portions. The truncus intermedius and right middle lobe bronchus should be anastomosed in a natural position. Anastomosis patency was confirmed using intraoperative bronchoscopy. Separation of the right upper and middle lobes and pericardiotomy at the inferior edge of the superior pulmonary vein are useful for mobilizing the right middle lobe. Death during hospitalization and treatment-related death did not occur. One patient developed pneumonia, and another developed a bronchopleural fistula.

CONCLUSION

We reported our technique of right lower sleeve lobectomy and our approach to perioperative patient management. Sharing knowledge is essential to completing this rare surgery.

摘要

目的

本报告回顾了我们行右下叶袖状肺叶切除术的经验,并描述了我们的手术技术和围手术期患者管理方法。

方法

我们回顾性分析了 11 例行右下叶袖状肺叶切除术治疗肺癌的患者。还研究了手术技术和围手术期管理。

结果

使用 4-0 可吸收单丝缝线进行支气管成形术。最深部位采用连续缝合;较浅部位采用间断缝合。中间干和右中叶支气管应在自然位置吻合。术中支气管镜检查确认吻合通畅。右上叶和中叶的分离以及上肺静脉下缘的心包切开术对于右中叶的游离很有用。住院期间无死亡,无治疗相关死亡。1 例患者发生肺炎,另 1 例发生支气管胸膜瘘。

结论

我们报告了右下叶袖状肺叶切除术的技术和围手术期患者管理方法。分享知识对于完成这种罕见的手术至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d25/11082492/e088cdf6475f/atcs-30-1-24-00026-figure01.jpg

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