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用于主肺动脉入路的扩大胸廓切开术：两例肺癌病例

Extended thoracotomy for main pulmonary artery access: Two lung cancer cases.

作者信息

Hayashi Kazuki, Kita Yusuke, Hanaoka Jun

机构信息

Department of General Thoracic Surgery, Omi Medical Center, Kusatsu, Shiga, Japan.

Division of General Thoracic Surgery, Department of Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan.

出版信息

SAGE Open Med Case Rep. 2024 Aug 19;12:2050313X241275025. doi: 10.1177/2050313X241275025. eCollection 2024.

DOI:10.1177/2050313X241275025
PMID:39165304
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11334133/
Abstract

This report details two cases of right upper-lobe lung cancer, of patients aged 62 and 56 years, requiring complex bronchoplasty and thoracoscopic surgeries. In both cases, owing to intraoperative complications, extended thoracotomies were performed to gain access to the right main pulmonary artery. The postoperative courses were uneventful, implying that this approach was safe. Uncomplicated postoperative recoveries underscore the need for adaptable surgical techniques, especially when traditional positioning fails. It emphasizes extending thoracotomy incisions for safer hilar structure access, offering insights for handling similar complex surgeries where standard methods falter.

摘要

本报告详细介绍了两例右上叶肺癌病例，患者年龄分别为62岁和56岁，均需要进行复杂的支气管成形术和胸腔镜手术。在这两例病例中，由于术中出现并发症，均进行了扩大胸廓切开术以暴露右主肺动脉。术后病程平稳，表明这种方法是安全的。术后恢复顺利突出了采用适应性手术技术的必要性，尤其是在传统定位方法失败时。这强调了延长胸廓切开切口以更安全地暴露肺门结构，为处理标准方法失效的类似复杂手术提供了思路。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/235f/11334133/c2490392fccd/10.1177_2050313X241275025-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/235f/11334133/0ed38ba83bc5/10.1177_2050313X241275025-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/235f/11334133/63b68ed62ed2/10.1177_2050313X241275025-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/235f/11334133/143c1199157c/10.1177_2050313X241275025-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/235f/11334133/c2490392fccd/10.1177_2050313X241275025-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/235f/11334133/0ed38ba83bc5/10.1177_2050313X241275025-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/235f/11334133/63b68ed62ed2/10.1177_2050313X241275025-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/235f/11334133/143c1199157c/10.1177_2050313X241275025-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/235f/11334133/c2490392fccd/10.1177_2050313X241275025-fig4.jpg

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本文引用的文献

1
A two-step surgical approach combining sternotomy and subsequent thoracotomy for locally advanced lung cancers requiring both right upper lung resection and superior vena cava reconstruction.一种两步手术方法，结合胸骨切开术及后续开胸术，用于需要同时进行右上肺切除和上腔静脉重建的局部晚期肺癌。
J Thorac Dis. 2018 Aug;10(8):4831-4837. doi: 10.21037/jtd.2018.07.77.
2
Robot-assisted thoracoscopic bronchoplasty.机器人辅助胸腔镜支气管成形术
J Vis Surg. 2015 Nov 18;1:20. doi: 10.3978/j.issn.2221-2965.2015.10.02. eCollection 2015.
3
Surgical resection for advanced lung cancer using the hemi-clamshell approach.
采用半蛤壳式入路对晚期肺癌进行手术切除。
Interact Cardiovasc Thorac Surg. 2017 Sep 1;25(3):462-468. doi: 10.1093/icvts/ivx142.
4
Extended surgery for T4 lung cancer: a 30 years' experience.T4期肺癌的扩大手术：30年经验
Gen Thorac Cardiovasc Surg. 2017 Jun;65(6):321-328. doi: 10.1007/s11748-017-0752-6. Epub 2017 Mar 27.
5
Pulmonary artery sarcoma resected via median sternotomy with thoracoscopic assistance.经正中胸骨切开术并在胸腔镜辅助下切除肺动脉肉瘤。
Surg Case Rep. 2017 Dec;3(1):11. doi: 10.1186/s40792-016-0279-6. Epub 2017 Jan 9.