Nomori H
Department of Surgery, Saiseikai Central Hospital, Tokyo, Japan.
Kyobu Geka. 1994 Jun;47(6):447-50.
A device of intercostal thoracotomy for preparing an intercostal muscle flap (IMF) is reported. In order to preserve a intercostal muscle (IM) at the level of thoracotomy, a thoracotomy is preformed by incision of lower edge of IM. By this technique, an intercostal thoracotomy can be performed with preservation of an IM. In a case with high risk of bronchopleural fistulas after pulmonary resection, this preserved IM can be easily used for preparing a muscle flap in order to wrap the bronchial stump or the anastomotic site of bronchoplasty. We have used IMF by this technique for 6 cases of lobectomy and 8 cases of bronchoplasty, which have high risk of postoperative bronchopleural fistulas. Of these 14 cases, there have been no postoperative bronchopleural fistulas, including the other complications. By this method of the intercostal thoracotomy with preservation of IM, IMF can be easily prepared without the use of other IMs, even when high risk of bronchopleural fistulas is newly anticipated after pulmonary resection. Therefore, the presented method of the intercostal thoracotomy is recommended for a routine thoracotomy.
报道了一种用于制备肋间肌瓣(IMF)的肋间开胸手术器械。为了在开胸水平保留肋间肌(IM),通过切开IM的下缘进行开胸手术。通过这种技术,可以在保留IM的情况下进行肋间开胸手术。在肺切除术后发生支气管胸膜瘘风险较高的病例中,这种保留的IM可轻松用于制备肌瓣,以包裹支气管残端或支气管成形术的吻合部位。我们已使用这种技术为6例肺叶切除术和8例支气管成形术患者制备IMF,这些患者术后发生支气管胸膜瘘的风险较高。在这14例患者中,未发生包括其他并发症在内的术后支气管胸膜瘘。通过这种保留IM的肋间开胸手术方法,即使在肺切除术后新出现支气管胸膜瘘高风险时,也无需使用其他IM即可轻松制备IMF。因此,推荐将所介绍的肋间开胸手术方法用于常规开胸手术。