Tao Hiroyuki
Department of Thoracic Surgery, Japanese Red Cross Society Himeji Hospital, Himeji, Japan.
Multimed Man Cardiothorac Surg. 2025 Apr 30;2025. doi: 10.1510/mmcts.2025.027.
The fissureless technique is useful for avoiding postoperative air leaks after pulmonary lobectomy or segmentectomy when the interlobar fissure is incomplete or fused. This technique is also useful for lung cancers with interlobar invasion or located in incomplete or fused fissures. In a recent case, we successfully utilized robotic-assisted thoracoscopic surgery to perform the fissureless technique on a patient diagnosed with lung adenocarcinoma. The tumour was located in the left superior segment (S6) and had spread beyond the incomplete fissure towards the apicodorsal segment (S1+2). The use of the fissureless technique allowed us to achieve a sufficient tumour margin, which is crucial for reducing the risk of recurrence. The pathological examination confirmed a diagnosis of node-negative papillary adenocarcinoma with pleural invasion. The patient experienced no recurrence at three years postoperatively. En bloc combined segmentectomy using the fissureless technique is useful to ensure adequate tumour margins for lung cancer arising in incomplete or fused fissures. Robotic surgery is suitable for this technique, which proceeds from a single direction.
当叶间裂不完整或融合时，无裂技术有助于避免肺叶切除术或肺段切除术后的术后漏气。该技术对于伴有叶间侵犯或位于不完整或融合叶间裂的肺癌也很有用。在最近的一个病例中，我们成功地利用机器人辅助胸腔镜手术对一名被诊断为肺腺癌的患者实施了无裂技术。肿瘤位于左上叶（S6），并已超出不完整的叶间裂向尖后段（S1+2）扩散。无裂技术的应用使我们能够获得足够的肿瘤切缘，这对于降低复发风险至关重要。病理检查确诊为伴有胸膜侵犯的淋巴结阴性乳头状腺癌。患者术后三年无复发。采用无裂技术的整块联合肺段切除术有助于确保对起源于不完整或融合叶间裂的肺癌有足够的肿瘤切缘。机器人手术适用于这种从单一方向进行的技术。
