Iizuka Shuhei, Oki Tomonari, Nakamura Toru
Department of General Thoracic Surgery, Seirei Hamamatsu General Hospital, 2-12-12, Hamamatsu, Shizuoka, 430-8558, Japan.
Gen Thorac Cardiovasc Surg. 2025 Sep 10. doi: 10.1007/s11748-025-02195-2.
Thoracoscopic surgery for stage III acute empyema is often limited by poor visualization and anatomical complexity. We developed a standardized, minimally invasive approach using a variable-view rigid endoscope and fixed port placement, regardless of disease extent or patient physique. The variable-view endoscope enabled a wide, adjustable field of view without moving the camera shaft, allowing safe access even in the confined thoracic space. This setup facilitated comprehensive adhesiolysis and decortication via a bidirectional approach by surgeons on both ventral and dorsal sides. Among 43 consecutive patients, all but one underwent successful thoracoscopic management, with favorable clinical outcomes and minimal complications.
胸腔镜手术治疗Ⅲ期急性脓胸常因视野不佳和解剖结构复杂而受到限制。我们开发了一种标准化的微创方法，使用可变视角硬性内窥镜和固定端口放置，而不考虑疾病范围或患者体型。可变视角内窥镜无需移动摄像头轴即可实现宽广、可调节的视野，即使在狭窄的胸腔空间也能安全进入。这种设置便于外科医生通过腹侧和背侧的双向方法进行全面的粘连松解和纤维板剥脱术。在连续43例患者中，除1例患者外，其余均成功接受了胸腔镜治疗，临床效果良好，并发症极少。
