课件：单孔胸腔镜技术治疗进展PPT课件.ppt

Diego Gonzalez-Rivas 等报导了一例55岁男性患者，肿瘤位于右上肺支气管管口阻塞并肺不张，行诱导化疗后，患者取左侧卧位，经右侧第5肋间一长约5cm手术切口，手术时间240分钟，术后病理提示一大小约1.7cm气管鳞癌，淋巴结癌转移（0/25） * Diego Gonzalez-Rivas等报导了一例左下肺袖式切除是胸腔镜下最复杂的手术之一，患者71岁女性，CT提示肿瘤位于左下肺支气管累计主支气管，患者取右侧卧位，左侧第5肋间长约5cm切口，手术时间250min，术后病理提示2.5cm肿瘤，无淋巴结转移（T1bN0M0 ）。 * Sequence of sleeve resection and anastomosis. (A) Exposure of left upper, lower and main bronchi. (B) Transection of left upper lobe bronchus. (C) Transection of main bronchus. (D) Retraction of artery and apposition of main and upper lobe bronchi with a 3–0 interrupted suture. (E) Posterior wall of anastomosis. (F) Interrupted 3–0 absorbable suture at the angle of anterior portion of the bronchial cartilage. (G) Continuous and interrupted sutures tied with the help of a thoracoscopic knot-pusher. (H) Continuous suture for the membranous portion of the bronchial membrane. (I) Use of endoscopic knot-pusher to tie the continuous suture with the last interrupted cranial suture to complete the anastomosis. * Diego Gonzalez-Rivas报导了非气管插管单孔胸腔镜下肺叶切除术，三例，第一例一50岁女性患者，右上肺一大小约4cm腺癌，无淋巴结转移，行右上肺叶切除，第二例一60岁男性患者，右上肺一大小约3cm肿瘤，行右上肺叶切除后完整清扫淋巴结，第三例是一68岁男性患者，左上肺一大小约4.2cm非小细胞肺癌并侵犯胸壁，行左上肺肺叶切除加淋巴结清扫。 * * * 53岁女性，CT提示右肺中叶和上叶前段GGO A 53-year-old female was admitted to our department for surgery. The patient suffered from cough, and a CT scan revealed two GGO lesions located in the Middle lobe and anterior segment of RUL (S3) respectively (Figure 1). Pulmonary function tests were normal. The patient was proposed for uniportal VATS subxiphoid middle lobectomy and anterior anatomic segmentectomy of the right upper lobe. * 可编辑 可编辑 单孔胸腔镜技术治疗进展 河南大学第一附属医院 胸心血管外科 杨忠信 zhongxin1985@163.com Wechat 经胸单孔胸腔镜治疗进展 经剑突下单孔胸腔镜治疗进展 病例分享 Uniportal History:单孔内镜下手汗症治疗 自1995年1月100例患者（46例女性、54例男性）接收双侧单孔内镜下手汗症治疗。 双侧同期在30分钟内完成 96%患者顺利康复并第2天出院 手术时间、住院时间缩短、疗效均优于开放手术 Vanaclocha.Uniportal endoscopic superior thoracic sympathectomy. Neurosurgery.2000 Apr;46(4):924-8. Uniportal History:经肋间单孔胸腔镜下肺楔形切除 Gaetano Rocco. Uniportal VATS wedg