Robicsek F
Heineman Medical Research Center of Charlotte, North Carolina.
J Heart Valve Dis. 1993 Jul;2(4):476-7.
The author's method for sternal re-entry in cases of extremely dense mediastinal adhesions is described. The anterior lamina and the spongiosa of the sternum is cut with an osteotome and the posterior lamina is divided using the Lebsche knife so as to leave the densely adhered patch of the posterior lamina on the underlying soft tissue. These bone fragments may be left in loco or, if the course of the operation requires it, they may be gently raised and peeled off. Removal of such a portion or portions of the posterior lamina does not appreciably weaken the sternum and safe sternal closure may be accomplished without difficulty.
描述了作者在纵隔粘连极其致密的病例中进行胸骨再次切开的方法。用骨刀切割胸骨的前板和松质骨，用莱布舍刀分离后板，以便将后板紧密粘连的部分留在下方的软组织上。这些骨碎片可以留在原位，或者，如果手术过程需要，它们可以被轻轻抬起并剥离。切除部分或全部后板不会明显削弱胸骨，并且可以毫不困难地完成安全的胸骨闭合。
